This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
FP Congressional Testimony Addresses Hidden Costs of Electronic Health Records
By James Arvantes • Washington
"Both in spite of and because of our experiences, I believe the benefits of (EHRs) over paper charts are numerous and profound," said Bort. "But because of the substantial cost and time barriers, it is quite difficult for small practices to purchase (systems)."
Bort spoke during a committee hearing on the unforeseen challenges of incorporating EHRs into small specialty practices. He was joined on the panel by physician representatives from the American Association of Neurological Surgeons, the American Psychiatric Association, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists. During the hearing's question-and-answer segment, Bort said the recent enactment of a Medicare payment bill that includes financial incentives to encourage the adoption of EHRs was a "step in the right direction," indicative of the type of legislation Congress should enact to help small practices defray the cost of EHRs.
During his testimony, Bort described his experiences with EHRs, saying his practice of 12 family physicians purchased a licensed EHR system in 2006 and began the arduous process of transitioning from a paper-based system to an EHR-based system.
"Only our integrity and our desire to help our patients kept us on-task," said Bort, who described himself as a family doctor living and working in the trenches of primary care.
Bort said that he and his colleagues never anticipated the ongoing cost of developing and maintaining an EHR system. The practice, which takes care of more than 28,000 patients at three separate locations in southwestern Ohio, southeastern Indiana and northern Kentucky, purchased the EHR system at an initial cost of $228,000. This cost, however, did not include the transfer of paper files to an electronic format or take into account the loss of productivity resulting from the time and effort expended by staff members to learn the system. The practice also pays its EHR vendor more than $258,000 annually to maintain the system.
"There was 'sticker shock' over initial outlays, and then the ongoing outlays and enhancements as we got further into the system." Bort said during the hearing. "We were dependent upon it, so (we) were obligated to upgrade it."
Bort also described some of the benefits of the EHR system, saying it provides convenience, accuracy and completeness while enhancing privacy and confidentiality. "When I am with my patient in the exam room, I am able to access lab results and check past history -- all at the click of a mouse."
EHRs also are essential to supporting and sustaining the patient-centered medical home, a team-based health care model that emphasizes care coordination and the management of chronic diseases, which leads, in turn, to better health outcomes at lower costs, Bort said.
Major Stumbling Block
"When our doctors visit patients at some of the hospitals, they are not able to access the patient information in our office because the hospital system and our office system are incompatible," he said.
"I would like to say we have achieved a paperless office," Bort said. "But we continue to be inundated with paper all day long. Our fax streams hundreds of prescription refill requests to us since there is no direct electronic communication between our system and the pharmacy or other providers."
Ralph Hale, M.D., EVP of the American College of Obstetricians and Gynecologists, said the lack of interoperability poses the greatest threat to patient privacy. Without interoperability, providers cannot communicate electronically, requiring someone to move medical records from one file to another and raising the possibility of security breaches, Hale said.
Common Concerns
"There is no silver bullet solution to America's broken health care system," said Rep. Nydia Velazquez, D-N.Y., chair of the Small Business Committee, during her opening statement. "There are, however, a number of ways to address the issue. For one, financial incentives to HIT users would help spur uptake."
Rep. Steve Chabot, R-Ohio, the senior Republican member of the committee, who also is Bort's patient, said, "the decision to implement health information technology in a small medical practice is considered an act of courage by many physicians."
Committee member Rep. Charles Gonzalez, D-Texas, meanwhile, said the federal government has "determined that HIT is an effective way of saving money," and would therefore continue to champion HIT initiatives.
"The train has left the station," said Gonzalez. The question, he added, is whether the federal government will factor in the experiences of physicians when making decisions about HIT. "I think (physician input) is totally essential or this is not going to work," he said.
Feds Push to Get Physicians on Board With e-Prescribing
Incentive Bonuses Begin in 2009
(7/23/2008)
HHS Targets Communities for EHR Pilot Project
Program to Pay Out $150 Million
(2/5/2008)
More From AAFP
Information Technology Used in Health Care
This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
Fee-For-Service Is Here to Stay for Now, Says Policy Expert
Legislators Air Differing Views on Health Care Reform
OTC Prescription Provision Creates Burden
House Bill Would Reform Medicare Payment
Pharmacists Prescribing? Absolutely Not, Says AAFP
AAFP, Others Asks CMS to Re-evaluate Penalty Timelines
Proposed CMS Rule on Overpayment Creates Difficulties
Nurse Education Demo Must Focus on Primary Care, Says AAFP
FP Advocacy Focus of Recent Visit to Capitol Hill
Funding Needed for Family Medicine Programs
Permanently Adopting Primary Care Pay Hike Could Save Billions
Study Highlights Role of CHCs in Health Care System
Ensuring Access to GME Is Focus of Message on Capitol Hill
Congress Passes Payment Patch, Fails to Repeal SGR
AAFP Continues to Press for SGR Repeal on Capitol Hill
Groups Demand That Congress Fix the SGR
PCMH Is Answer to Medicare Payment Problems
Physician Groups Unite to Call for SGR Repeal
Threatened Medicare Payment Cuts Cause Chaos for FPs
AAFP, Medical Organizations Push for SGR Repeal
Focus of Conference Call is Shared Savings, Advance Payment
FPs Can Expect Slight Changes in Medicare Pay for 2012
HHS Approach to Essential Health Benefits Falls Flat
CMS Delays Implementation of 'Sunshine Act'
Congress Works Out Temporary Solution to SGR Cut
Community-based Residencies Would Benefit From House Bill
GME Funding to Remain Level in 2012
House Rejects Measure to Block Medicare Pay Cut
House Addresses Medicare Payment Cut
AAFP Backs Tavenner as New CMS Administrator
Supercommittee Fails to Address SGR
Overcoming Scarce Resources to Enact Health Care Reform
Medicare Payment: Value Is as Important as Volume
AAFP President-elect Makes Return Visit to Capitol Hill
Insurance Exchanges, CO-OPs Might Provide Opportunity for FPs
AAFP Members Speak Out on Title VII Funding
Campaign Addresses Need for Medicare Payment Reform
AAFP Continues to Press Congress for Payment Solution
AAFP Leaders Take On Washington
Campaign Focuses on GME Outreach
'Family Medicine Matters,' AAFP Members Tell Congress
AAFP Outlines Suggested Changes for CO-OP Program
Groups Call on Supercommittee to Address Medical Liability Reform
Grassroots Efforts to Repeal SGR Continue
Bill Linking Mandatory Education to Prescribing Not Needed
Blended Payment Model Gives Boost to Primary Care Services
AAFP Joins AMA, Other Groups in Calling for SGR Repeal
Eliminating SGR May Come With High Price
Tobacco Oversight Must Include Cigars, Say AAFP, Other Groups
AAFP Rallies Congress of Delegates on Medicare Payment
AMA Task Force Focuses on Fixing the SGR
2012 Physician Fee Schedule Needs Work, Says AAFP
New Task Force Takes Steps to Better Value Primary Care
Deficit-reduction Plan Must Eliminate SGR, Says AAFP
Physicians File Lawsuit Over RUC, CMS Relationship
Policy Brief Explains HHS Insurance Exchange Plans
