I read with great interest the front-page article, “Using HIT as ‘Game Changer’ in Health and Healthcare,” (Nashville Medical News, March 2010).

 

As a practicing physician of a 31-person, large urology group in Nashville (and one that has been on an EHR (electronic health record) since 1996 and about to migrate to their third), this article paints a very rosy picture regarding the future of HIT … specifically as it relates to medical practice … but does not deal with the reality of day-to-day operations that the physician provider has to endure.

 

Yes, it is true that the Obama Administration has stimulus dollars for physician practices to adopt EHR’s and show “meaningful use,” which has yet to be truly defined by government. However, if you were to talk to physicians on the ground that have tried to transition from paper to electronic, it is a very arduous process and most will see a 20 percent decrease in productivity for a period of three to six months during the migration. 

 

With decreasing reimbursement, rising overhead costs (yes, doctor’s offices do have overhead just like every small business), the ongoing threat of a 21 percent cut in Medicare reimbursement to physicians due to the Sustainable Growth Rate formula that was not addressed by the Health Care Reform Act, it is no wonder that physicians have been slow to utilize technology. The proposed dollars, which are paid over three years, do not even begin to cover the costs of implementation and loss of revenue. It has yet to be shown that having a truly functional EHR does result in increased efficiency or care of the patient. I do agree that the potential is there, but the platforms available are far from prime time.

 

Doctors have, for the most part, been labeled as obstructionists along many fronts. In this case, many are sitting on the fence … and for good reason … waiting for a better product so as to be able to continue to take care of their patients and yet pay the bills to keep their offices open. I would propose that the next time a “panel of experts” are convened regarding healthcare, why not invite a few physicians that are not working in the corporate world, but carrying out the mundane day-to-day work of providing care to the patient? You would be surprised what one might learn.

 

 

Raoul S. Concepcion, MD, FACS

Urology Associates

2801 Charlotte Avenue

Nashville, TN 37209