| A recent report, published online in the New | | | | doctors cannot find products that meet their |
| England Journal of Medicine, found that doctors | | | | needs in a market saturated with 400 EMR |
| who use electronic health records (EHR) say | | | | vendors? Is it because these products tend to be |
| overwhelmingly that such records have helped | | | | designed for hospitals - big customers - instead of |
| improve the quality and timeliness of care. Yet | | | | small practices? |
| fewer than one in five of the nation's doctors has | | | | A recent article in The New York Times ("Most |
| started using such records. Most doctors in | | | | Doctors Aren't Using Electronic Health Records") |
| private practice, especially small practices, lack the | | | | concludes with this testimonial: "Do I see more |
| financial incentive to invest in computerized | | | | patients because of this technology? Probably no," |
| records. In fact, only 8.6 percent of small | | | | Dr. Masucci said. "But I am doing a better job with |
| practices (1-3 doctors) have started using EHR, as | | | | the patients I am seeing. It almost forces you to |
| compared to 50 percent of large practices (more | | | | be a better doctor." Is it reasonable to expect a |
| than 50 doctors). | | | | technology to force you to be a better doctor or |
| The key reason for slow EHR adoption rates | | | | see more patients a day? Does the number of |
| seem to be economic: providers, already | | | | patients per day measure adequately health care |
| squeezed for reimbursement by payers, lack the | | | | quality or even productivity? Does technology play |
| financial incentive to make a significant - often as | | | | such an ambitious role in other professions? Would |
| high as $20,000 per doctor - investment in EHR, | | | | you expect a journalist to say something like "Do |
| and undergo the painful and costly conversion | | | | I write more articles because of Microsoft Word? |
| process from paper. Experts agree that EHR | | | | Probably no. But I am doing a better job with the |
| would be adopted faster in a consumer-driven | | | | articles I publish. Microsoft Word almost forces |
| health care system, where innovation benefits the | | | | you to be a better journalist." |
| entrepreneurial provider. In the absence of a | | | | In a consumer-driven market, fewer patients |
| consumer-driven health care market, the | | | | would visit a practice that lacks modern |
| government, i.e., the taxpayers, subsidize | | | | documentation processes and more doctors |
| technological progress, shifting the system | | | | would develop realistic business-driven |
| selection and pricing decision-making from health | | | | requirements for EMR. The market would guide |
| care providers to bureaucrats. | | | | the EMR vendors and the process of EMR |
| That decision-making today is not easy: 54 | | | | adoption would become dramatically simpler and |
| percent of doctors without EHR said that not | | | | easier in terms of matching functionality, |
| finding an electronic health record that met their | | | | convenient conversion process, and affordable |
| needs was a "major barrier" to adoption. Why | | | | pricing. |