Push is on for doctors to embrace 'health IT'

March 15, 2009|By Noam N. Levey | Noam N. Levey,Tribune Washington Bureau

VERO BEACH, Fla. -With his stethoscope decorated with three tiny koalas, Dennis Saver looks every bit the family doctor as he steps into the examining room of his small practice on Florida's Treasure Coast.

When Saver begins to examine his patient, however, he does something that four out of five doctors in America do not do: He pulls out a computer.

The little black Toshiba, its edges worn to the bare metal, now gets more use than the stethoscope and has become key to the care Saver gives his patients. It organizes medical histories, test results, prescriptions and other data that were once a jumble of paper records.

Saver's laptop, and the system behind it, put him on the cutting edge of what President Barack Obama and many experts say is a critical step to improving the nation's health care system while reining in costs.

It is known as "Health IT," an idea that promises to reduce medical errors, avoid unnecessary tests and procedures, and identify better treatments.

The concept is not new. But in an age when auto mechanics routinely turn to computerized records before changing a tire, most doctors and others in the health care system have lagged far behind in adopting modern information technology even as they embrace state-of-the-art science and technology to treat their patients.

Now Obama is betting he can change that with $19 billion from the economic stimulus legislation he signed last month.

With his health reform agenda on the line, the president has asked the federal bureaucracy to do in a few months what doctors, hospitals and high-tech companies have failed to do in more than a decade: drag the medical profession into the computer age.

It's an immense challenge.

There is still debate over what an electronic health record should look like and who should have access. Nor is there consensus about how to give different computer records systems the interoperability that you see in automated teller machines the world over.

Some doctors and hospitals have already begun on their own.

Saver and the nine other physicians in his practice decided to take the plunge 3 1/2 years ago. The move fundamentally changed the operation of the one-story office.

Gone are thousands of manila files that filled a big room. Doing away with those files has enabled the practice to cut its records staff from seven to three.

The office eliminated 2 1/2 more positions in the billing department because clerks no longer have to struggle with doctors' handwritten notes.

The laptop enables Saver to quickly check lab results, and costly tests aren't repeated because a lab result is lost or an image misplaced, he said.

Thanks to warnings embedded in the electronic health record, or EHR, Saver can monitor his patients' prescriptions to avoid harmful interactions. In case of a drug recall, he can check the database in minutes to find out whom to notify.

Elsewhere, there are even more promising signs. Childrens Hospital Los Angeles, which installed an EHR system five years ago, has all but eliminated errors in prescriptions, according to hospital officials.

In the U.S., 17 percent of physicians use electronic health records, according to a survey published last year in the New England Journal of Medicine. A barrier to wider adoption has been up-front expense. Installing the system can cost more than $30,000 per physician. Even though Saver and his partners bought a less expensive system, they had to take out a $178,000 loan.

"Being a family doctor is a hand-to-mouth operation," Saver, 56, said. "And most physician practices have bought these systems by taking food off their tables. ... It's been something of an act of faith."

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