EHRs too costly for small medical practices, panel told
Reaching a tipping point in the adoption of electronic medical records by small or specialty medical practices will likely require some form of congressional intervention, said health care experts at a hearing held July 31 by the House Small Business Committee.
High implementation costs, concerns about confidentiality and a lack of interoperability have slowed adoption of electronic records by doctors in fields such as psychiatry, pediatric, neurosurgery and obstetrics/gynecology, panelists told lawmakers.
“The decision to implement health information technology in a small medical practice is considered an act of courage by many physicians,” said Rep. Steve Chabot (R-Ohio).
Rep. Nydia Velázquez, committee chairwoman (D-N.Y.), noted that the cost of “EHR installation comes to over $32,000 dollars per physician” and that ongoing maintenance fees push the cost of electronic records higher.
“For small health care providers with limited resources, these upfront costs are enough to break the bank,” Velázquez said. “Whereas 57 percent of large care center use electronic health records, only a handful of solo practitioners do.”
Dr. Thaddeus Bort, a partner at the Family Medical Group in Cincinnati, called on lawmakers to enact tax incentives or other forms of financial incentive to hasten adoption of electronic medical records.
“We’re drowning in overhead,” Bort said, noting that in the fiscal year that ended June 30, his practice paid its EMR vendor more than $258,000.
Congress should also create incentives for vendors to adopt EHR standards that would promote interoperability and make basic systems more affordable, he said.
But the structure of incentives for EHR adoption is a contentious issue. The director of the Congressional Budget Office has testified that one approach would be to limit Medicare payments for doctors who don’t use electronic medical records.
“I think many doctors would get their hackles up” and stop seeing Medicare patients, said Dr. Ralph Hale, executive vice president of the American College of Obstetricians and Gynecologists. “Doctors don’t respond well to penalties and forcefulness.”
The challenges of adopting EMRs notwithstanding, lawmakers and doctors agreed that widespread adoption is inevitable. What remains to be determined is how and how fast that will occur -- and who will pay for it.
“I believe in due course electronic, records will be part of the standard of care” said Rep. Charles Gonzalez, (D-Texas).
About the Author
John Pulley is a freelance writer based in Arlington, Va.