The findings aren’t new, but the sheer size of the study confirms what earlier research suggested.

Docs know they provide better care, faster, when they switch from paper to electronic medical records. They just don’t want to spend the money to heal more patients and kill fewer.

According to the New England Journal of Medicine, a poll of 2.758 doctors (with a 62 percent response rate) found that 17 percent were using some form of electronic record system.

But those who do use electronic record systems rave about them.

Among the small number of respondents who had fully functional electronic-records systems, most physicians reported the positive effects of the system on the quality of clinical decisions (82%), communication with other providers (92%) and patients (72%), prescription refills (95%), timely access to medical records (97%), and avoidance of medication errors (86%). Furthermore, 82 to 85% reported a positive effect on the delivery of long-term and preventive care that meets guidelines.

But those results probably underestimate the importance of electronic records because they don’t consider the benefit that patients will get when it’s easy for them to import all their own medical records into the personal health systems I wrote about earlier this week.

A New York Times story about the study asked some doctors to explain the situation and then explored ideas for fixing the situation:

Dr. Paul Feldan, one of three physicians in a primary care practice in Mt. Laurel, N.J., has looked at investing in electronic health records, and decided against it. The initial cost of upgrading the office’s personal computers, purchasing new software and obtaining technical support to shift to computerized patient records would be $15,000 to $20,000 a doctor, he estimated. Then, during the time-consuming conversion from paper to computer records, the practice would be able to see far fewer patients, perhaps doubling the cost.

“Certainly, the idea of electronic records is terrific,” Dr. Feldan said. “But if we don’t see patients, we don’t get paid. The economics of it just seem so daunting.”

Several doctors interviewed for the story said the government should help them pay to upgrade their record keeping. And many government officials apparently agree. Medicare has launched a five year study that will pay individual doctors in 12 cities up to $58,000 to make the transition.

Neither the NY Times article, nor any story I’ve seen on the issue, presses doctors to justify the decision to against spending such a small amount (relative to the annual revenue of any moderately successful practice) to improve care and reduce potentially fatal errors.

Another question that always occurs to me — but always goes unanswered — is this: how does any insurer underwrite a medical malpractice policy without demanding a doctor take every reasonable step (including electronic records) to avoid errors and thus lawsuits?

Another big question that never gets answered: why don’t regulators just mandate that doctors make the switch in, say, six months, rather than studying the situation for five years before deciding whether to spend billions of taxpayer dollars to buy equipment for wealthy people?

None of these questions are trivial. The Institute of Medicine estimated in 2006 that prescription errors alone killed or sickened 1.5 MILLION AMERICANS PER YEAR.

Systems that would have prevented nearly all of these errors — and improved care for 300 million Americans — have existed for about a decade. In that time, doctors have made more than 12 million drug errors, and still no one can figure out how to convince them to buy some software and a few computers.

Popularity: 1% [?]

Share This

This entry was posted on Thursday, June 19th, 2008 at 5:57 pm and is filed under General News.You can follow any responses to this entry through the RSS 2.0 feed.You can leave a response, or trackback from your own site.