Doctors, Time To Take Your MedicineDoctors, Time To Take Your Medicine

For most family-practice doctors, swallowing the $25,000 or more needed to adopt electronic records has been too bitter a pill. So the American Academy of Family Physicians is sweetening the incentive, hoping to get tens of thousands of MDs on electronic systems by 2005.

In one of the medical industry's biggest pushes yet to get doctors to adopt electronic-health records, the academy--the largest professional organization for family physicians, with 55,000 active members--said last week it has negotiated discounts of 15% to 50% from makers of software and other gear needed for electronic records.

"The No. 1 reason why doctors say they've looked into [electronic-health records] and decided not to deploy a system is the expense," says Dr. Michael Fleming, president of the group and a practicing family physician. Fleming has been quoted estimates for his 10-doctor physician group of $200,000 to $600,000 for software, hardware, and services needed to implement electronic records. Typically, such systems cost $25,000 to $50,000 per practice, excluding hardware, according to the family-physicians' organization.

Vendors in the program include A4 Health Systems, a provider of health-records and practice-management software; GE Medical Systems Information Technologies; Hewlett-Packard; and Siemens, a provider of medical gear and hosting services. Other participants include MedPlus Inc., a subsidiary of Quest Diagnostics Inc., which provides lab services. MedPlus could provide the interfaces needed for electronic lab orders and test results to be sent between doctor offices and Quest labs.

The academy set a goal in 1999 to have at least half of its members adopt electronic records by 2005. Today, less than 10% of members have. But there's been progress--95% of the members use E-mail, says the group's executive VP Dr. Douglas Henley.

Pressure to adopt electronic records doesn't only come from that group. The business-sponsored health-care watchdog group LeapFrog considers electronic records in rating health-care providers because it believes it helps improve efficiency and quality. And the U.S. Health and Human Services Department advocates doctors and hospitals adopt electronic records because they have potential to reduce medical errors, improve collaboration, and cut the costs associated with manual processes and duplicated medical services that result when access to patient information is hampered by paper files.

In addition to discounts, vendors are promising financing so doctors can spread the cost over three to five years. "Many practices, particularly the smaller ones, can't afford to make huge investments, especially all at once," says Larry Stofko, VP of IT strategy at St. Joseph Health System, which operates 15 hospitals in California and Texas and a 125-physician group practice.

Yet cutting the cost won't be enough to sway many doctors, who cite a lack of interoperability, as well as integration problems among the record systems and doctors' practice-management systems. Also, key standards don't yet exist, such as a national patient-ID system to ensure that clinical information sent electronically belongs to the correct patient. However, Fleming says vendors participating in the academy's program have agreed to develop interfaces that let records and practice-management systems communicate and to meet de facto federal government standards.