Category Archives: Research

Doctor EHR Adoption Could Reach 30% by 2011, Survey Finds

Nearly 18% of U.S. physicians in 2006 had an electronic health record system, and that figure could increase to 30% by 2011, according to a new survey by the Millennium Research Group, United Press International reports.

However, the survey also found that most nonhospital-affiliated small practices will find it difficult to afford the technology and justify the disruption it will cause the practice. Small practices that are not affiliated with hospitals represented nearly 70% of all office-based physicians in 2006.

This will remain true for small practices despite government efforts to aid in the adoption of health IT. However, those efforts, such as allowing hospitals to help affiliated physicians by donating or subsidizing the cost of EHR systems, will help drive growth, the survey suggested (United Press International, 7/17).

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Some cautious of additions to IRS health IT ruling

By: Joseph Conn / HITS staff writer

Story posted: May 17, 2007 – 9:54 am EDT

Initial reactions to the long-awaited decision last week by the Internal Revenue Service to join HHS and the CMS in clearing a path for hospitals to subsidize healthcare information technology systems to affiliated physicians were overwhelmingly positive.

But in the passing of a few days and with sober reflection, not everyone sees the new IRS policy as an unalloyed good thing.

Healthcare lawyer Andrew Blustein, a partner with Garfunkel, Wild & Travis, Great Neck, N.Y., while joining the early voices saying the IRS ruling is “wonderful news,” also urged caution. “It’s a major step forward, but people need to realize there are some additions (in the ruling) that may not fit their particular program.”

HHS and the CMS last summer issued safe harbors to the federal anti-kickback law and exceptions to Stark laws prohibiting inducements for referrals in separate documents totaling more than 70 pages. Hospitals can qualify for the HHS and CMS dispensations by providing under specific conditions subsidized electronic medical-records systems and support to physician practices.

After the HHS and CMS rulings, attention turned almost immediately to the IRS. Not-for-profit hospitals were cautioned by their lawyers that IT contributions to for-profit organizations such as physician practices, though legal under the new Stark and anti-kickback modifications, could still jeopardize hospitals’ tax-exempt status.

By November 2006, the American Hospital Association sent a letter to Lois Lerner, director of the exempt organizations division at the IRS, asking for a broad ruling favoring the IT subsidies. Lerner’s response came last Friday in a two-page “field directive” memo she sent to two department directors under her division.

It said: “We will not treat the benefits a hospital provides to its medical staff physicians as impermissible private benefit or inurement in violation of section 501(c)(3) of the code if the benefits fall within the range of health IT items and services that are permissible under the HHS EHR regulations and the hospital operates in the manner described below.”

The IRS conditions were:

  • Hospitals must enter into health IT subsidy agreements with physicians receiving IT items and services.
  • Hospitals and physicians must comply with HHS rules.
  • “The health IT subsidy arrangements provide that, to the extent permitted by law, the hospital may access all of the electronic medical records created by a physician using the health IT items and services subsidized by the hospital.”
  • “The hospital ensures that the health IT items and services are available to all of its medical staff physicians.”
  • “The hospital provides the same level of subsidy to all of its medical staff physicians or varies the level of subsidy by applying criteria related to meeting the healthcare needs of the community.”

The key provisions of the HHS and CMS policies dovetailed, but the IRS memo outlines some unique features, according to Blustein.

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Government And Private Medical Sharing Technology To Begin Pilot Program In Tampa

April 19, 2007 VitaBeat

The U.S. Defense Department will be partnering with the private sector hospitals in the Tampa, FL area soon, according to an Armed Forces Press Service report. The goal is “to share electronic medical record keeping expertise and technology.”

This partnership is a pilot program, which is part of President Bush’s initiative to align the U.S. medical community’s implementation of computerized record keeping within the next 10 years, according to a U.S. Health Affairs representative.

An additional goal of the Department of Defense is to have the new system initiated and actually begin running it within one year. The clinical data for inpatients needs to be added to the current outpatient medical record keeping system.

The ultimate goal is to develop and establish an inpatient system of medical records that can be accessed by the Departments of Defense and Veterans Affairs.

Passwords and encryption computer security measures will be implemented to keep the medical records safeguarded, while partnerships with the private medical sector will allow both entities to gain needed expertise and experience.

This type of partnership between the government and the private sector’s medical community is already ongoing through the government’s commercial-source provider of the TRICARE program, which is the military personnel’s HMO.

This is why the Tampa, FL area is ideal for this program, because there are currently approximately 700,000 beneficiaries who live in that area and receive care through the military facilities or through TRICARE.

The new program will bring speed, accuracy and ease with up-to-date computerized electronic filing versus paper filing of medical records for service members, their families and their beneficiaries to provide quality medical care.

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Survey: E-health records don’t have to jeopardize privacy

Harris Poll also finds most adults comfortable with existing state and federal health privacy laws

Heather Havenstein March 26, 2007 (ComputerWorld) — Electronic health records can be recorded and shared without jeopardizing privacy, according to a Harris Interactive Inc. survey of 2,337 adults that was released today.

In the survey, 63% of respondents said that a move to electronic health records could be done without endangering their privacy, while 25% disagreed. In addition, 60% of those surveyed said that existing state and federal health privacy laws provide a “reasonable level” of privacy.

The survey, which was done in January, was designed with Alan Westin, a professor of public law and government at Columbia University who studies electronic health records.

The survey showed “about a two-thirds majority are ready to accept the potential benefits of electronic health records systems if solid privacy and security rules are applied,” Westin said. “However, about one quarter of the public remains skeptical and worried about such systemic computerization, and it will take highly robust and transparent new privacy and security programs to overcome these fears.”

The survey also found that seven in 10 U.S. adults are generally satisfied with the way doctors and hospitals handle and protect personal health information. However, 50% noted that they believe patients have lost control over how organizations like insurance companies, employers and government health agencies use their personal health data.

The survey comes at a time when privacy concerns are at the forefront of federal government and health care providers’ efforts to help spur the adoption of electronic medical records and the creation of nationwide networks to share them.

Last month, the U.S. Government Accountability Office released a report  that said the federal government has not yet come up with a way to tie together the various ongoing initiatives it has to tackle privacy concerns associated with electronic medical records.

In addition, one of the country’s oldest regional health information organizations was shuttered  late last year, citing privacy as one of the challenges to continuing its operations.

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Tech firms in a fever about health

SAN FRANCISCO — IBM, Intel, Microsoft and other tech companies are increasingly betting that the health care industry will help them grow as their traditional markets mature.

Microsoft CEO Steve Ballmer is to kick off a health care tech conference in New Orleans today. The health care Information and Management Systems Society show is expected to draw 900 exhibitors and 25,000 doctors, hospital staffers and others.

It’s Microsoft’s latest health care push. The software giant acquired medical database-maker Azyxxi last year and now has more than 600 employees working on health care projects, Vice President Peter Neupert says. Health care “is a huge sector of our economy,” yet it is still relatively low-tech, he says.

Americans spent almost $2 trillion on health care in 2005, according to the most recent study from the Department of Health and Human Services. Yet, many doctors and nurses “still use pen and paper and clipboards” to record patient data, says Scott Eckert, CEO of PC-maker Motion Computing.

Better computer systems could improve data accuracy, prevent duplication and reduce errors, says IBM general manager Dan Pelino.

It could also allow tech companies to sell a lot of hardware and software. That’s important, since growth in traditional tech markets is slowing. For example, U.S. PC shipments rose only 1.2% last year from 2005, says researcher Gartner. But overall health spending on technology jumped a bigger 5%.

Tech companies are responding:

• Intel and partner Motion Computing this month unveiled a laptop for doctors and nurses. It features a germ-resistant surface that is easily disinfected, plus a digital camera to snap pictures of patients.

• Hitachi this month announced plans to acquire Archivas, a company that makes databases to store digital X-rays and other data. Hitachi plans to add Archivas software to storage hardware and other products it already sells. “It’s where the growth is,” Executive Vice President Jack Domme says.

• IBM has more than 4,000 staffers working on health care products. One is a nationwide patient database it’s developing with the Health and Human Services department. The database would store patient data regardless of which hospital or doctor is visited.

Health care will likely become even more lucrative in coming years. The nation’s 79 million baby boomers are aging, with the oldest turning 61 this year. As they require more medical attention, the need for better health care technology will become even more apparent, Microsoft’s Neupert says.


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Analyst sees growth in EMR market, but not hyper-growth

By Heather B. Hayes Government Health IT

The physician-based electronic medical record (EMR) market is growing at a fast pace, but not as fast as many in the industry would like to believe, according to a market analysis by the consulting firm of Frost and Sullivan. The findings are based on a study of metrics, including vendor sales data and end-user surveys.

Steve Tobin, a Frost and Sullivan industry analyst who authored the report released Feb. 21, estimated that EMR adoption is climbing among all sizes of physician practices, with an overall market growth rate of about 20 percent.

“There’s strong technology growth, to be sure, but we’re still talking about a multiyear, even decade-long implementation for the entire market,” Tobin said. “EMR solutions will continue to have a lot of market penetration, but it’s just not as hyper-growth as some people have speculated that it is.”

Early adopters and larger practices are driving much of the growth, he said. In smaller practices, the slow materialization of financial benefits from EMRs frequently reduces the incentive to buy. However, “current [vendor] offerings are providing different business models, such as the ASP [application service provider] model, which may help penetrate financially restrained practices,” Tobin said.

Still, Tobin said he believes doctors in small practices are beginning to recognize the efficiency, clinical improvement and potential financial benefits of EMRs and are becoming more sophisticated in their knowledge. When these physicians decide to buy, they tend to demand integrated solutions from vendors, he said.

Also, many vendors are getting ahead of themselves by pushing the quality capabilities of EMR solutions; most physician practices are not ready for that step in the technology evolution, according to the report. “Those with that level of sophistication are very few in the market at this point,” Tobin said. “Most physicians are still grappling with implementation, getting used to it, doing the basics and getting their practice involved with it.”

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Study: Patients Favor Electronic Records


NEW YORK — Doctors looking to attract new patients may want to buy an electronic medical record system because a new survey slated to be released Monday found that a majority of consumers said the technology plays a role in their selection of a physician.

The good news for doctors is that patients may offset the cost of such a purchase: Fifty-one percent of consumers said they would be willing to pay for the service if the price was reasonable.

Only 10 percent of doctors surveyed said they had the technology, according to a survey by Accenture, a consulting, technology services and outsourcing company. Eighty-six percent of the doctors cited the cost of implementing and/or maintaining the system as a concern. Physicians also worried about the time it would take to implement a program and potential privacy risks for patient information.

According to the American Medical Association, studies suggest that the cost of implementing a system is $30,000 per doctor. Ongoing costs can range between $3,000 and $15,000 a year per doctor.

Numerous health experts tout electronic medical records as a way to lower increasing health care costs and reduce medical errors.

The survey results reflect the public’s growing understanding of how electronic medical records can help improve care, said Dr. Brian Kelly, executive director of Accenture’s Health and Life Sciences practice.

“(Consumers) are saying ‘It is so important I would pay for it at a reasonable cost,” Kelly said. The survey didn’t ask what consumers would consider reasonable.

Two-thirds of the 600 consumers interviewed said that an electronic health record was at least slightly important in their physician choice with 24 percent saying it was very important and the same amount saying it was moderately important.

Seventy-seven percent of consumers said they would have greater access to and more control over their medical records if they were in electronic form. Other benefits of electronic records cited by consumers included the capacity to confirm information provided by a doctor and the ability to ask physicians better questions.

Ninety percent of doctors said electronic medical records would make sharing and obtaining information easy. Other positives noted by physicians included more comprehensive patient information and fewer lost records.

Accenture surveyed randomly selected consumers online last year while it interviewed 100 doctors by phone.

The survey has a margin of error of plus or minus three percentage points.