July 12, 2005
A Health-IT Highway Without Cars
By Girish Kumar
The front lines of healthcare are small and medium-sized medical practices that deliver 70 percent of America's healthcare. Initiatives by Health and Human Services and the proposed bills of Sens. Clinton, Frist, and others have put the spotlight on technology. Yes, these are positive catalysts for IT adoption. Standards and interoperability will accelerate the process 25 percent faster than would otherwise happen.
However, adoption can move still faster if additional steps are taken to guide our efforts:
Incentivizing small and medium-sized physician groups to adopt electronic medical records (EMRs). For parallels, consider the financial services industry and adoption of credit cards. Government, insurers, and providers must work together to devise an equation that benefits all. One possible approach is to establish Medicare fee schedules with EMR discounts.
Following closely on these incentives is pay-for-performance. Health plans are already taking tentative steps in this area, but a standardized and broader system for pay-for-performance will be possible through widespread EMR adoption.
We should also beware of too many standards. Physician practices are the nodes of delivery for the healthcare infrastructure. As different standards are proposed by public and private interests, it's important to remember that interoperability without the nodes is like a highway without cars. Government is forging the vision, and private industry can collaborate to make sure the small and medium-sized physician offices make their way onto the highway.
A fourth point is that EMR technology should pay for itself. For small practices, this often isn't the case, as reflected in low adoption rates. Streamlined workflow, increased doctor efficiency, clinical data collection, and decision support represent one side of the coin -- and improving workflow and reducing costs are helpful. But on the other side of the coin, a truly valuable EMR addresses coding, reimbursement management, and payor interactions to help drive practice profitability. Consider that if your EMR system pays for itself with increased collections, the practice will be highly motivated to completely adopt the system.
Policy makers and the private sector must work together to turn guiding tenets into practical realities.
About the Author
Girish Kumar is a founder of the ambulatory EMR company eClinicalWorks.
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