Although government and industry officials have been touting the patient safety benefits of electronic health records, physician practices have been slow to adopt the technology – primarily because of its cost and complexity.
In a Commonwealth Fund study last spring, 84 percent of practices surveyed said cost is a major impediment to adopting EHRs.
The problem, physicians say, is that while they have to make the upfront investment, most of the financial benefits accrue to payers and other healthcare players.
Vendors in the $1.5-billion EHR industry have apparently gotten the message: They’ve been seeking new opportunities to bolster the ROI for physician practices. One of the largest vendors, Allscripts, has made potential clinical trial revenue a top selling point in its 2006 marketing strategy. It released data earlier this year that showed how one practice, Holston Medical Group in Kingsport, Tenn., generates about $3 million annually in research revenue.
Research, particularly for pharmaceutical companies, is a huge expense. Many believe EHRs could make it easier and cheaper and say physician practices could sell de-identified patient data to cover the costs of technology and boost slimming margins.
In a new twist to secondary uses of data, Practice Fusion, Inc., a San Francisco-based company launched last August, is poised to launch an EHR that is free to physicians.
The “completely hosted, community-based model” EHR will be subsidized on the back end by selling de-identified data to insurance groups, clinical researchers and pharmaceutical companies, said CEO Ryan Howard.
A key benefit to Practice Fusion’s product will be automatic synchronization, Howard said. A patient’s records accessed online by several doctors simultaneously will be maintained by the Web-based host and continually updated in a central location. Also, there will be virtually no start-up costs or inconvenience, he said.
“We’ve eliminated the typical two years needed for implementation of hardware and databases, and the need for consultants – a very painful way to solve the [healthcare IT] problem,” he said.
While Practice Fusion’s approach may be a solution to the heavy cost burden behind physicians’ lag in healthcare IT adoption, data-sharing issues are likely to face controversy.
In its Sept. 11 report titled “Toward a National Framework for the Secondary Use of Health Data,” the American Medical Informatics Association recommended increased transparency and public awareness around the secondary use of health data. “There is a need for a national framework for the secondary use of health data that includes a robust infrastructure of policies, standards and best practices,” the AMIA said.
According to Jodi Daniel, director of the Office of Policy and Research at the Department of Health and Human Services’ Office of the National Coordinator for Health Information, state privacy laws currently supersede federal privacy laws, making a national healthcare privacy law impossible.
Howard said he does not expect data-sharing will be a concern to physicians who accept the free EHR product from Practice Fusion.
“Every healthcare vendor is selling data,” he said. “Everyone has this data, but we’ll have more of it and it will be real-time and aggregated. We will be able to help drive the patient community toward better care by providing data on the causes and trends of certain conditions over time.” n