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Colleagues,

As reported in the New York Times...In its economic recovery package, the Obama administration plans to spend $19 billion to accelerate the use of computerized medical records in doctors’ offices...Washington is about to embark on another ambitious government-guided effort to jump-start a market — in electronic health records...

“What’s underappreciated is the implementation challenge,” said Dr. Blackford Middleton, chairman of the Center for Information Technology Leadership, a research arm of Partners Healthcare in Boston. “This is really not a technology problem,” observed Erik Brynjolfsson, an economist at the Sloan School of Management at the Massachusetts Institute of Technology. “It’s a matter of incentives and market failure.”...Clever engineering, smart business models and favorable economics are the key ingredients of widespread adoption and commercial success.

A crucial bridge to success, according to experts, will be how local organizations help doctors in small offices adopt and use electronic records. The new legislation calls for creation of “regional health I.T. extension centers.” In a letter to the White House and Congress last month, Dr. Middleton and 50 other experts emphasized the importance of these centers and pointed to the Primary Care Information Project in New York City as a model.

The New York project’s brief history, beginning two years ago with $27 million in financing, offers a glimpse of the challenges of wiring small physician practices. The New York team, headed by Dr. Farzad Mostashari, an assistant commissioner in the city’s health department, started by bringing in decision-support experts in medicine to study how doctors work, so the technology would be easier to use. Team members considered writing their own software for simple, Web-based electronic health records, but abandoned that idea once they understood that patient records would have to be tightly linked to billing — a physician’s financial lifeblood.

The staff worked closely with its software supplier, eClinicalWorks, to tweak and tailor the system. They began rolling out the records a little more than a year ago. They are now used by more than 1,000 physicians, mainly in poorer neighborhoods, whose workplaces include two hospital outpatient clinics, 10 community health centers, 150 small group physician practices and one women’s jail, serving a total of one million patients. “Our experience here is that it’s just hard,” Dr. Mostashari said. “It’s not impossible.”

Read on at: http://www.nytimes.com/2009/03/01/business/01unbox.html?th&emc=th

ENJOY!

CC

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Replies to This Forum Entry

Posted the same article before reading this post, CC. There will be a lot of support work necessary around making the EMR useful to physicians.
Parvati,

I agree. The deeper we get into thinking about the stimulus/ehr issue, the more clear it becomes that training/facilitation will be the key success factor. This will require a major nationwide effort. In crisis is opportunity!

CC

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