June 24, 2008

It was interesting timing, to say the least.

Just days after I spoke with Augusta Kairys, Highmark's vice president of provider relations about the Pittsburgh-based health insurer's efforts to support a higher rate of technology adoption amongst its providers, a report in The New England Journal of Medicine found that fewer than one in five doctors are using electronic health records.That paltry sum seems all the more surprising when one considers that doctors overwhelmingly agree that EHRs and related technologies have the ability to improve quality of care. So where's the disconnect that is preventing many doctors from adopting a technology that most agree will be beneficial?

from the New York Times:

Bringing patient records into the computer age, experts say, is crucial to improving care, reducing errors and containing costs in the American health care system. The slow adoption of the technology is mainly economic. Most doctors in private practice, especially those in small practices, lack the financial incentive to invest in computerized records. The national survey found that electronic records were used in less than 9 percent of small offices with one to three doctors, where nearly half of the country's doctors practice medicine.

Larger practices have been much quicker to adopt the technology. But even among practices of 50 or more doctors, only about half have implemented EHR technology. As the New York Times article points out. Adoption has been slowed, mostly, because doctors aren't able to justify the costs from a business perspective. For the most part, the (financial) benefits of EHRs will be realized by insurers and hospitals.

Private and government insurers and hospitals can save money as a result of less paper handling, lower administration expenses and fewer unnecessary lab tests when they are connected to electronic health records in doctors' offices. Still, it is mainly doctors who bear the burden making the initial investment.

"We have a broken market for electronic health record adoption because the people who gain financially are not the people who pay," said Dr. Blackford Middleton, a health technology expert at Partners Healthcare, a nonprofit medical group that includes Massachusetts General Hospital in Boston.

Hopefully, that last sentiment will cause more insurers to follow Highmark's lead in providing financial assistance to doctors who implement EHRs. Just because insurers won't "own" this bit of technology, doesn't mean they won't benefit from it. And as such, this could be an area worthy of more of insurers' technology investment dollars.

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