Instead, physicians face Medicare and private insurance payment cuts. Little assistance is available for the investment in HIT. And uncertain interoperability standards and rapid technological changes can very quickly make this year’s investment obsolete. Many physicians in solo and small practices are understandably reluctant to take the HIT plunge.
The initial cost of purchasing HIT for a small practice is typically at least $50,000 per physician. Physicians face additional, ongoing costs in staff training and hardware and software updates as well. And many physicians see significant efficiency losses for months and sometimes years after upgrading to an electronic health record system.
Still, with interoperable, shareable electronic records, all physicians treating a particular patient can have the full story. A patient’s paper record kept in her physician’s office shows only a slice of her medical history, potentially missing important information from the patient’s other physicians, including allergies to medication, test results, and the results of particular therapies.
Without a shared electronic record, a physician relies on the recollection of each patient, which is often unintentionally incomplete. A patient may be uncertain about the name or dosage of a medication, fail to remember the date of a screening examination, or lack results of lab tests ordered by another physician.
A physician’s access to the full story with shareable electronic records is important to the care of all patients and can be particularly relevant for patients who have inconsistent contact with health care providers. Often, these patients get care in various settings, including physician offices, community clinics, and emergency departments. Because these patients tend to have a higher incidence of chronic disease, they may greatly benefit from the sharing of medical information.
Clearly, Congress wants to move us to full adoption of HIT. Beginning in 2013, all plans must comply with a uniform standard for electronic transactions, including eligibility verification and health claims status.
In 2014, uniform standards must allow automatic reconciliation of electronic funds transfers and HIPAA payment and remittance; use standardized and consistent methods of health plan enrollment and claim edits; use unique health plan identifiers to simplify and improve routing of health care transactions; and use standard electronic claims attachments.
Uniformity and standardization can help address one of the major roadblocks to physician adoption of health information technology.