Report: More is needed to fuel physician adoption of health IT

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Reasons to adopt health IT (information technology) systems are insufficient and financial incentives are needed to encourage healthcare providers to adopt IT that allows interconnectivity to improve patient care, according to a new report released by Connecting for Health, a public-private collaborative.

The report - Financial, Legal and Organizational Approaches to Achieving Electronic Connectivity in Healthcare - proposes a level of financial incentives necessary to significantly increase the adoption of electronic health records (EHRs) by doctors. Adequate incentives are metered in the report at a rough level of $3 to $6 per patient visit or $0.50 to $1.00 per patient per month

Initial financial incentives for small and medium sized practices will need to cover most of the costs of adopting EHRs, but that over time, these incentives will transition to performance-based incentives, according to the report. The range of incentives is estimated to be $12,000 to $24,000 per full time physician per year. The analysis also shows that the business case for the incremental adoption of applications of health IT is sound, as long as the applications are interoperable, and suggests that e-prescribing and on-line tools for chronic disease management are good starting points, said the report.

"The goal of this Working Group was to examine the barriers faced by ambulatory care providers in adopting health IT and then to use any available empirical data to identify potential starting points and near-term opportunities for physician practices to adopt healthcare IT," said John Glaser, PhD, CIO at Partners HealthCare Systems Inc., and chair of the Working Group. "This report articulates a qualitative approach to examining the kinds of incentives needed to encourage the of adoption electronic health records."

"Electronic health records have the potential to help reduce medical errors, lower costs and empower patients," said Carol Diamond, MD, managing director at the Markle Foundation and chair of Connecting for Health. "However, without the widespread adoption of electronic health records by small and medium physician practices - that represent more than half of the practices in this country - and the requirements for achieving the level of interconnectivity necessary to allow for the effective exchange of health related information, the benefits of information technology cannot be fully realized. We hope this report sparks a full and frank debate over the issue and that it can be a first step toward realizing the potential of electronic health records."

To overcome the organizational barriers to the adoption of health IT systems, communities need to assess their readiness for data sharing, including an evaluation of their technical, clinical and organizational capabilities, the report said. Leadership will also play a crucial role because the report finds that communities will need a neutral convener to catalyze action and encourage participation in the system.

"To fully realize the potential of electronic connectivity in healthcare, it is imperative that we have commonality in place - that is, some common approach to organizing information sharing activities at the local or regional level ," said Nancy Lorenzi, professor of Biomedical Informatics and assistant vice chancellor for Health Affairs Vanderbilt University Medical Center Informatics Center, Eskind Biomedical Library and member of Connecting for Health's Working Group on Financial, Organization and Legal Sustainability of Health Information. "Without careful planning for the way regional efforts organize themselves and the standardization of some minimal information sharing practices, we will fail to achieve the ability to safely and effectively exchange information, leaving us no better off than we are now."