Doctors Seek Guidance on Electronic Records

While some physicians want more information on how to implement EHRs, conflicting needs between vendors, payers and providers have formed a logjam that makes doing so difficult.

SAN FRANCISCO—Physicians use outmoded procedures to treat and monitor chronic conditions. Thats according to Sophia Chang, director of the Chronic Disease Care Program at the California HealthCare Foundation, who addressed attendees at a conference Thursday on improving chronic disease care.

Once evidence has shown a treatment to be effective, it takes 17 years to become part of routine care, Chang said, quoting a study from the Institute of Medicine. Computerized clinical support systems could reduce the lag time, she said, especially if the systems could tap into a patients medical record.

But the health care delivery world is not integrated, and these problems require a systemswide solution, she said. "The challenge is, how do you try to create this system in a fragmented world" in which hospitals, outpatient physicians, specialists and other entities simply dont communicate?

"The big bugaboo is physician adoption," said Mark Leavitt, director of ambulatory care at HIMSS (Healthcare Information and Management Systems Society), a nonprofit professional group.

Even though rates for using health IT in physician offices remain low, he said, belief in its usefulness has risen. Doctors at conferences now want "fewer talks on why EHR [electronic health records] and more on how to implement it," he said.

Leavitt described the barriers to adoption as a "logjam" between IT vendors, health care providers and health care payers. Payers are becoming more willing to compensate doctors more for using health IT products, but "they cant just write a check to everyone who has a computer."

Vendors cant sell a $1,000 computer system without providing implementation and on-site customer support, and physicians are afraid theyll make the wrong investment.

Leavitts group is working on a certification program to help solve these problems, he said, but certification itself wouldnt be enough.

Next Page: The national health IT coordinator calls for small-office solutions.