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 released last spring, some 84 percent of practices surveyed said cost was a major impediment to adopting electronic health records. The problems, physicians say, is that while they have to make the upfront investment – and the resulting changes in their work flows – most of the financial benefits accrue to healthcare payers and other players in the market.
Vendors in the $1.5 billion EHR industry have apparently gotten the message and have been seeking out new opportunities to bolster the ROI for physician practices. For instance, one of the largest vendors, Allscripts, has made potential clinical trials 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, Tennessee – generates about $3 million annually in research revenue.
Research, particularly for pharmaceutical companies, is a huge expense. Many believe electronic health records have the potential to make it easier and cheaper – and that physician practices can sell their de-identified patient data to cover the costs of technology and boost slimming margins.
Now there’s 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 explained. 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 cost or inconvenience, according to Howard.
“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,” Howard said.
Practice Fusion’s approach may be a solution to the heavy cost burden behind physicians’ lag in healthcare IT adoption, but data-sharing is in the limelight and 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,” 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,” Howard 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.”
- Editorial Director Jack Beaudoin contributed to this story