New report highlights hurdles for small medical practices in adopting electronic records

Connecticut doctors have been slow to adopt electronic medical records, in part because a majority of the state’s physicians work in groups with four doctors or fewer. That means they don’t have a big institution, with deep resources, to help make some of the large technological investments needed to switch over to an electronic system.

A new study suggest that networks of small medical practices-called “independent practice associations”-is one possible resource for doctors in small practices to overcome hurdles in adopting and using electronic health records.

The study, conducted by the Center for Studying Health System Change, concludes that independent practice associations, first formed in the 1970s, “can serve as model in how to provide coordinated assistance with [health IT] activities to otherwise independent and relatively small physician practices.”

Connecticut has at least one large IPA, established as a physician network in the 1990s. It’s currently working with the Connecticut State Medical Society to provide more than 20 small primary-care practices with intensive IT training through a grant to help them achieve full medical-home accreditation.

But it was created more of a network of doctors and likely doesn’t have a huge capacity to help physicians with things like adopting electronic medical records. So the report may be more useful in laying out the challenges Connecticut doctors face than in helping them arrive at a solution.

Here’s more from the Center’s summary of the report:

Often because of inadequate technical and financial resources, small practices’ adoption of electronic health records (EHRs) and other HIT lags larger physician practices. And, despite broader trends of physicians moving to larger practice settings, a sizeable share of physicians is likely to practice in small groups for the foreseeable future.

Along with providing technical support, the IPAs also cultivated trusted and HIT-knowledgeable physician leaders to help less-technologically savvy clinicians make the jump from paper to electronic records.

“A key finding is that identifying physician leaders who can bridge the gap between technology and clinical care is a powerful way to help physicians in small practices overcome barriers to HIT adoption,” said Paul B. Ginsburg, Ph.D., HSC president and NIHCR research director, who coauthored the study with Timothy K. Lake, Ph.D., and Tricia Collins Higgins, Ph.D., M.P.H., both researchers at Mathematica Policy Research.