CHICAGO – Despite broad-based efforts to encourage physicians to use health information technology and electronic prescribing, IT’s penetration among physicians remains woeful. Costs and lack of return on investment remain the biggest stumbling blocks.
The lack of results prompted several members of the American Health Information Community, meeting in Chicago last month, to ask why the government isn’t taking a stronger hand in pushing adoption.
Preliminary data from a 2007 survey of physician implementations of electronic medical records didn’t show much progress over a similar 2006 report, said David Blumenthal, of Massachusetts General Hospital’s Institute for Health Policy.
Blumenthal’s comments, along with the lack of progress in getting physicians to adopt e-prescribing, were delivered at the 17th meeting of the American Health Information Community, held in Chicago in conjunction with the annual conference of the American Medical Informatics Association.
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Blumenthal said his organization 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 is defined as providing a full range of functionality.
Barriers to physician adoption continue to be significantly financial. Blumenthal said 69 percent of early respondents to the 2007 survey cite a lack of capital as the reason why they’re not adopting EHRs, while 55 percent cite the uncertainty of achieving a return on investment.
Those 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.”
An announcement at the meeting by Kerry Weems, acting administrator for the Centers for Medicare & Medicaid Services, also drew some heat. Weems said the CMS would require the use of electronic prescription standards when physicians submit prescriptions that are to be covered by Medicare. However, she acknowledged that there is 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 the 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.