CHICAGO – Despite broad-based efforts to encourage physicians to use health information technology and electronic prescribing, penetration among physicians of IT remains woeful, and the chief barrier remains financial.
The lack of results prompted several members of the American Health Information Community, meeting in Chicago on Tuesday, to ask why the government wasn't taking a stronger hand in pushing adoption.
Preliminary data on a 2007 survey of physician implementations of electronic medical records didn't show much progress over a similar 2006 report, said David Blumenthal, of the Massachusetts General Hospital Institute for Health Policy.
Barriers to physician adoption continue to be significantly financial. Sixty-nine percent of early respondents to the 2007 survey cite a lack of capital as the reason why they're not adopting EHRs. Fifty-five percent cite uncertainty of achieving a return on investment.
The financial barriers need to be overcome, said Lillee Gelinas, vice president and chief nursing officer of VHA Inc.
"We've said monetary incentives are clearly a key component of adoption," she said. "Why is this not part of the conversation? We've got to overcome this."
"It's clear why the results are poor; for most physicians, it's not someone else's money – it's theirs," said Charles Kahn III, president of the American Federation of Hospitals. "We'll have to do something big that's going to have to change the dynamic. The survey shows the obvious; it ain't going to happen unless the government, the payers or the patients are going to be willing to pay for it."
Blumenthal said his organization has sent surveys to 5,000 practicing physicians beginning in July. About 400 responses, out of an expected total of 3,000, have been received so far.
Of those, about 39 percent say they have deployed electronic health record functionality. But that's when providers can self-define an EHR; the percentages go down to 14 percent when they're presented with a minimum set of functionality as defined by the Institute of Medicine, or 5 percent when the EHR system provides a full range of functionality.
An announcement at the meeting by Kerry Weems, acting administrator for the Centers for Medicare & Medicaid Services, also drew some heat from panel members. Weems announced that CMS would require electronic prescriptions submitted to Medicare use standards to qualify for reimbursement. However, Weems acknowledged that there was no way to push physicians to submit all Medicare-paid prescriptions electronically.
"There's not anything out there that will get you to the tipping point of widespread adoption," said Craig Barrett, chairman of the board for Intel Corp. "It's not going to happen."
"Just look at the numbers - they're pitiful," Kahn said. "They're growing by the hundreds, not the thousands."
Further discussion of how the government could take a larger role in pushing adoption of e-prescribing was put on the agenda for AHIC's January meeting.