Doctors Go Digital
Imagine that on a Thursday next February, you get your annual physical in the major northeast city you call home. Friday, you catch a plane for a Colorado ski trip. Unfortunately, by late Saturday afternoon you’re in an emergency room staring at an x-ray of one of your legs after taking a bad fall on the slopes. Imagine now that your emergency room doctor has access not only to the x-ray and whatever personal information you provided upon being admitted, but to your entire medical history, including the summary of the physical you had roughly 48 hours ago. This is possible because your primary care physician entered the data from your physical into an “electronic health record” (EHR), which the emergency room doctor is able to access via a nationwide digital network.
While the above scenario is today possible in only a few parts of the United States, and even there only to a limited extent, the Obama administration has dedicated approximately $27 billion, under the Health Information Technology for Economic and Clinical Health Act (HITECH), to making it a nationwide reality. Aside from the convenience promised to our upscale vacationer, advocates of EHRs and other emerging health information technologies argue that ushering health care providers firmly into the digital age will result in less expensive, more efficient, and more effective health care services for all. With that goal in mind, the bulk of the HITECH funding, which was passed as part of the 2009 “stimulus” bill, is slated to be used to incentivize Medicare and Medicaid providers to switch from traditional paper to electronic records over the next five years.
Under the HITECH programs, Medicare providers considered “eligible professionals” can qualify for up to $44,000 over five years, beginning in 2011, while Medicaid providers can receive up to $63,750 over six years. For most providers, the incentives will cover only a fraction of the necessary overall investment. A recent study published in Health Affairs determined, in looking at the cost of implementing an EHR system in 26 primary care practices in north Texas, that “an average five-physician practice [will have an] implementation cost [of] an estimated $162,000, with $85,500 in maintenance expenses during the first year.” Policymakers hope, however, that providers will quickly realize the benefits of electronic records — in terms of both better care for their patients and more efficient management for their practices — and thus be willing to shoulder the larger, long-term cost.