Doctors wanted for e-records

Development of a nationwide system for electronic health records hinges on widescale adoption by physicians and group practices. But U.S. doctors are reluctant to adopt technology, even if they are given equipment and software, a health care information technology leader said at a conference this week.

Unless officials from small doctor's offices and small physicians groups embrace electronic health records, they cannot meet President Bush's goal of developing such records within a decade, said Dr. David Brailer, National Health IT Coordinator at the Department of Health and Human Services.

For electronic records to work in the health industry, they must be adopted by doctors in large urban practices and by their counterparts in small, rural practices. The country can't be divided into a nation of health IT haves and have-nots, Brailer said, speaking at the Health IT Summit sponsored by the eHealth Initiative.

Experts have estimated that a national system for electronic health records could cost up to $700 billion.

Leonard Schaeffer, chairman and chief executive officer of WellPoint Health Networks Inc., an insurance company based in Thousand Oaks, Calif, said company officials have convinced doctors to adopt technology, but the process wasn't easy even though the hardware or software was free.

WellPoint officials offered to provide 19,000 doctors with a free system for electronic prescriptions or a free office automation package. But the insurance firm had to contact 25,000 doctors before it found a pool of 19,000 willing to take the offer worth $40 million for hardware and software. Most opted for the office automation package, and only 2,700 signed up for e-prescriptions, based on a Dell Inc. Axim handheld computer. Schaeffer said those statistics reflected the low adoption of e-prescribing in the United States, where almost 90 percent of doctors still write prescriptions by hand.

Brailer said U.S. doctors face a negative business case with electronic records systems and HHS. Insurance companies need to develop financial incentives to spur adoption of technology incentives such as pay-for-performance and pay-for-use inducements, Brailer added.

Officials at the United Kingdom's National Health Service have devised a simple way to get doctors to use electronic health records, said Richard Granger, NHS' director general for IT. NHS officials plan to spend $64 billion during the next decade on electronic health records systems. Starting this year, payments to doctors will be based on the quality of care data they provide the agency. No data means no payment, Granger said.

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