Federal stimulus dollars provide incentive for doctors, hospitals to adopt digital system
Jennifer Gomez sat at her doctor’s office in Evanston after her appointment, waiting for a handwritten prescription. Minutes later, her doctor wondered why Gomez was still in the office.
What the 20-year-old Loyola University Chicago student didn’t know was that not only had the prescription been sent to the pharmacy, it also was ready to be filled.
“The prescription was at my pharmacy before I even walked out of the office, because everything is computerized,” Gomez said of her experience at a clinic run by NorthShore University HealthSystem. “I was surprised, expecting to wait.”
Gomez is among the first patients to experience the benefits of electronic medical records, as the nation’s health care industry moves from paper files to computerized records. The momentum is expected to pick up this year as federal stimulus money to help with the transition is starting to arrive at doctor offices and hospitals across the U.S.
Already, hundreds of hospital operators nationwide, including the largest ones in the Chicago area such as NorthShore, have entered the digital age, allowing patients to access email alerts to remind them of appointments, request medical test results or easily connect with insurance companies, pharmacies and other key players of the health care system.
Industry observers project the digitizing of medical records could save the nation’s health care system hundreds of millions of dollars because it would reduce or eliminate redundant testing and the occurrence of errors in patients’ files, among other benefits.
“If you are an emergency room doctor and you are trying to figure out what to do next, an electronic medical record may prevent you from having to do another” test, Dave Seaman, chief executive of Pronger Smith Medical Care, said of expensive procedures such as MRIs and other diagnostic imaging that can cost hundreds or thousands of dollars.
About 90 percent of the medical care providers at Pronger Smith, which has more than 60 doctors, physician’s assistants and nurse practitioners in Tinley Park and Blue Island and handles about 50,000 patients each year, have implemented electronic medical records, Seaman said.
As more health care systems adopt electronic records, consumers also should benefit from the efficient sharing of medical information.
“Most physicians will tell you that if you give me your prescriptions that you are on and show me your lab tests, that tells a pretty good snapshot of a patient,” Seaman said. “(Without electronic records), you’d have all these lab test results, and you would have them in 50 to 100 sheets of paper, if the patient even had them.”
The shift to electronic medical records has been in the works for years, but obstacles such as the cost of digitizing files and concerns about patient privacy have held back many hospitals and physician practices.
A key hurdle has been the doctors themselves. The physician community is highly fragmented, numbering in the hundreds of thousands, with more than 60 percent of office-based physicians in single or a small practice of four doctors or fewer, according to the American Medical Association. So coordinating implementation has been a battle.
These doctors also have been concerned about the affordability of information systems, which can cost tens of thousands of dollars for a small practice. The doctors also worry whether the systems will work and whether they can communicate with other computerized medical systems.
NorthShore digitally connected health records to its three hospitals in Evanston, Glenview and Highland Park, along with its medical group offices, in 2003 at a cost of $35 million. In 2009, its hospital in Skokie, which it purchased in 1999, “went live for an additional cost of approximately $5 million,” NorthShore said.
In 2009, Congress passed and President Barack Obama signed into law the Health Information Technology for Economic and Clinical Health Act, which was part of the federal stimulus legislation known as the American Reinvestment and Recovery Act. The legislation aims to provide more than $20 billion to get doctors and hospitals to use electronic medical records, computerized prescription systems and other health information technology.
And doctors for the first time are eligible to begin getting more than $40,000 in extra Medicare payments this year if they upgrade their health information technology. If doctors can’t demonstrate the “meaningful use” of certified electronic health record system by 2015, they face reduced Medicare payments, federal health officials say.
In Illinois, the state received more than $18 million in federal stimulus dollars to support a statewide health information exchange that will allow medical care providers to share data electronically in a collaborative, secure system, Gov. Pat Quinn’s office said. That, analysts say, should eliminate another hurdle that doctors have said prevented their practices from buying a system: the fear it might not work with a system made by another company.
The financial support is paying off, the nation’s top health official said.
“In the last two years, the share of primary care providers using a basic electronic health record has gone from under 20 percent to nearly 30 percent,” Kathleen Sebelius, secretary of Health and Human Services, told hospitals and health systems in February at the Health Information and Management Systems Society annual meeting in Orlando, Fla.
“When President Obama came into office, only two in 10 doctors … used even a basic electronic health record system. Over the last two years, we’ve created unprecedented momentum behind health information technology.”
But challenges are expected to remain for smaller and solo doctor offices, analysts say.
“The initial startup and transition is difficult,” said Dr. Stephen Sproul, a family physician at Advocate Lutheran General Hospital in Park Ridge.
“You have to learn a whole new way of documenting your patient care and managing your patient interactions, and that change is difficult,” Sproul said. “You start to see a light at the end of the tunnel after about a year. Physicians have to be patient, but they will see results.”