| There is now more than $29 billion devoted to | | | | practices remains well below 30% nationally. |
| healthcare IT over the next several years thanks | | | | Critics argue that the Obama money would be |
| to the Obama stimulus plan, specifically the | | | | best spent on preventative care, educational |
| HITECH act. How will this affect individual | | | | programs, and increasing access to quality |
| patients and their physicians? | | | | healthcare for the poor. Even within the |
| | | | | framework of the HITECH act, upstarts claim |
| Several small clinics in the Silicon Valley are | | | | that it unfairly rewards established vendors, with |
| beginning to make a full commitment to Electronic | | | | outdated technology, rather than encouraging |
| Medical Records. Initial costs often exceed | | | | innovation. Unlike the corporate world, where |
| $30,000 or more including the software packages, | | | | open source initiatives, outsourcing, and an |
| hardware for running the software, IT labor for | | | | increase in standards-based frameworks have |
| installation and configuration, and to provide | | | | lowered the cost of business productivity |
| training and support for the physician users. Even | | | | applications, healthcare IT technology remains a |
| some alternative healthcare service providers, | | | | relatively closed market, dominated by a few |
| such as chiropractors and acupuncturists, are | | | | large vendors who use relationships with large |
| deploying electronic medical records. Several | | | | hospitals to fend off incursions by smaller vendors. |
| startup companies, for instance Fremont, CA | | | | One site, best-emr.com, hopes to provide an |
| based PracticeChoice, Inc., and MA based | | | | unbiased forum for physicians to submit reviews, |
| eClinicalWorks, are beginning to offer "hosted", | | | | comments, and criticisms of vendor packages, |
| and web versions of EMR and other features. | | | | large and small. According to their site, "We will |
| | | | | present the reader with clear and compelling |
| Given the size of the Obama plan, more vendors | | | | reviews of the best EMR solutions in the market." |
| are rushing into the space, and many open source | | | | |
| projects are available. Prices are dropping. | | | | Considering the security and privacy concerns of |
| eClinicalWorks offers a feature rich EMR for | | | | digital health records, it is reasonable to put more |
| around $500 per month per doctor, while upstarts | | | | trust in larger, established players to safeguard |
| like PracticeChoice are offering provider accounts | | | | their systems. Public opinion on EMR seems to |
| as low as $99 per month, making it affordable to | | | | vary from mistrust to outright paranoia, fear of |
| smaller clinics like chiropractor Dr. Rishi Shahani, DC | | | | the theft or mishandling of records being the |
| of Vitality Health Services. "I used to spend hours | | | | most oft cited criticism on sites like Digg, where |
| every evening after seeing patients doing | | | | many articles have 100s of comments from |
| paperwork. Now I leave [the clinic] and it's already | | | | opinionated readers. Still, small players do have |
| done!" | | | | some credibility. "Our systems use more modern |
| | | | | software technology [than larger competitors] |
| Besides the productivity gains for physicians, EMR | | | | that has been used in banking and payment |
| provides patients options for electronic access to | | | | systems, Homeland Security, and government |
| physicians. The Noe Valley Clinic, located in upscale | | | | systems safely for years," responds Neeraj |
| Noe Valley, a neighborhood in San Francisco home | | | | Datta, CEO of PracticeChoice. "The answer to |
| to many of the urban upper class, uses EMR to | | | | security concerns is not merely to trust in |
| allow "Email access to your doctor" and "Online | | | | established products, but rather to use open, |
| personal health records and prescription renewals," | | | | peer-reviewed, and independently audited |
| according to their site. While this is also being | | | | software technology, like open source." |
| offered by healthcare giants Blue Cross, Kaiser, | | | | |
| Sutter Health, and others, it is remarkable that a | | | | Most agree, however, that it will be several years |
| small boutique clinic can now provide such | | | | before the result of the spending initiative is |
| advanced services securely, and affordably. | | | | determined. Perhaps imperfect, President Obama |
| | | | | might later be credited for providing the ounce of |
| EMR is not without its detractors. Despite several | | | | prevention that will help heal a suffering US care |
| years of active marketing by established EMR | | | | system. If it fails to deliver on its promises, it |
| vendors, adoption at hospitals and private | | | | could be a bitter - and expensive - pill to swallow. |