The cost, physician practice size, and lack of technical resources still present barriers for small healthcare providers in adopting electronic health records and participating in the meaningful use incentive program.
Solo practitioners and small practices find it difficult to locate a lender willing to offer them an unsecured loan, said Sasha Kramer, MD, a solo practitioner dermatologist in Olympia, Wash. Others who try to finance their electronic health record system with the vendor have no leverage in negotiating terms because of their limited market share.
Kramer was among public and private health IT experts and physicians who spoke at a June 2 hearing of the House Small Business Committee’s health care and technology subcommittee.
Two years ago, Kramer purchased and deployed an EHR system that cost more than $41,000. It took four weeks to learn and integrate. Although quick by many standards, it reduced the number of patients she saw by 75 percent, from 4 per hour to 1 per hour, and slashed her revenues, she explained.
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Two years later, she has to replace that EHR because her vendor was acquired and no longer supports her system. “I have to invest $30,000 in a new system and take time again from my patients to learn it,” she said.
“Despite these factors, I fully support the infusion of health IT into physician practices. It is a critical component in improving the healthcare delivery system and, more importantly, providing optimal patient safety and care,” Kramer said.
For instance, she has each patient’s chart and information for each visit and can track drug interactions and medication refills and past medical history. “It is much easier to communicate with other providers, and I am able to operate more efficiently with less employee time spent pulling and organizing charts,” she said.
Farzad Mostashari, MD, national coordinator for health IT, is familiar with the difficulties of solo physicians and small practices acquiring and deploying health IT. Before coming to the Office of the National Coordinator for Health IT (ONC) in 2009, he led the New York Primary Care Information Project where in three of the city’s most underserved communities in one year’s time more than 1,000 providers went live with EHR systems.
ONC has funded 62 regional health IT extension centers nationwide that are now assisting more than 70,000 mostly primary care physicians with EHR purchase, implementation, project management and other technical challenges of establishing and becoming meaningful users of certified EHRs. ONC also lists more than 700 certified EHR products on its website.