Over the weekend, I read an interesting article on PhysiciansPractice.com that basically said most doctors are not capable of being successful with adopting EHR systems. It was such a defeatist attitude that I just had to comment on it here. I mean, come on. We’re dealing with professionals who grew up at the top of their classes in school, merited entry into a highly-selective, Mensa-level institution called medical school, and then survived all the hurdles through residency and possibly a subspecialty fellowship. Hollywood worships doctors and spins out TV shows and movies about these alleged smartest members of our society. And we’re supposed to buy that an EMR system is just too hard to adopt? Just because it’s a computer system, I suppose?
While I do agree that we should study why most physicians have not adopted an EHR system in their practices, I think there are many more logical reasons for the so-called “failure” to adopt. To me, it seems less likely to be a true failure and more likely an active decision (or refusal). I also think that there are obvious considerations with the potential to contribute to this decision.
1. Paper is easier to master than EHR systems. Doctors can scribble a few, quick notes and not worry about format, about as complex as using a Post-It sticky note. In 99.9% of patient visits, the notes never see the light of day by an auditor or insurance company. No one ever really asks to see them. The payments are just rendered by the insurance company automatically when an electronic claim is sent in.
2. Paper is cheaper and takes no investment of time or training and very little immediate investment of money. A patient chart the thickness of a ream of paper basically costs about $4, plus pen ink, and doctors get a ton of free pens from various vendors of just about everything.
3. Incentive programs only work right now if you see a significant number of Medicare or Medicaid patients, and not all doctors do. I was only seeing 6% of my patient population as Medicare in 2010.
4. The hoops established by CMS will only get more intrusive and obtrusive in the future, and most doctors know this due to simply reading newspapers and newsletters.
5. The potential penalties for non-adopters are around 1.5-2% of Medicare/Medicaid-only income. A lot in absolute terms, but not so when relatively speaking.
So my final thought is that, while I love my EMR system, I’m not doing it for money or necessity. I’m doing it because along with the right EMR system comes other efficiencies, environmental friendliness, and hopefully a better quality of patient care. Oh, and back to my original point, yes, I actually think that pretty much all doctors are perfectly capable of adopting an EMR system.
Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at firstname.lastname@example.org.