Free Daily Headlines :

  • COVID-19
  • Money
  • Election 2020
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Money
    Election 2020
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

Connecticut doctors slow to adopt electronic record-keeping

  • by Arielle Levin Becker
  • September 15, 2010
  • View as "Clean Read" "Exit Clean Read"

The federal government is set to roll out a massive incentive program aimed at making electronic record-keeping the standard in health care. But Connecticut doctors lag behind when it comes to making changes that experts say could save time and money, reduce medical errors and duplicate tests, and improve patient care.

Among state doctors, 25.8 percent used electronic medical records, and less than a quarter prescribed drugs electronically, according to a 2008 survey by the Connecticut State Medical Society. In a national survey conducted the same year by the National Center for Health Statistics, 41.5 percent of doctors reported using electronic medical records in their office-based practices.

Connecticut hospitals fared better. According to a recent study, less than 12 percent of U.S. hospitals used either basic or comprehensive electronic health record systems to track patients in 2009. In Connecticut, 7 of the 28 hospitals that responded to the survey reported using basic or comprehensive systems.

“It is an absolutely essential ingredient to making the health care system work better,” said Dr. Ashish Jha, an associate professor of public health at Harvard and an author of the hospital study.

Proponents of electronic medical records say the potential benefits are immense. Prescriptions transmitted electronically don’t carry the risk of a pharmacist misreading a doctor’s handwriting, and some electronic records systems can check for possible negative drug interactions with other medications a patient takes.

Even more significantly, Jha said, electronic records that multiple health care providers can access could help avoid duplicated tests that commonly occur when patients receive care at two or more places that don’t share records. Avoiding extra tests would save time, money, and, in the case of some tests, unnecessary exposure to radiation.

A 2005 study estimated that using electronic record systems that could share information between providers could save nearly $80 billion a year. Jha predicted the figure would now be closer to $100 billion.

“We are at such an abysmal level,” he said of health providers’ current use of EMRs.

Many health care providers in Connecticut embrace the concept behind electronic medical records. But they say there are significant barriers to getting to the sort of system the federal government will begin pushing next year through cash incentives – and, later, through penalties for providers who haven’t made the shift.

Matthew C. Katz, executive vice president of the Connecticut State Medical Society, said cost and caution are major barriers. An EMR system can cost between $5,000 and $25,000 per doctor and require long periods of staff training, he said, a hardship for the state’s many small medical practices.

Stories abound of doctors who bought systems from companies that later went out of business, or sytems that don’t meet the new federal standards.

“Many physicians are sitting back and saying, ‘I’m going to wait 6 months or a year for the dust to settle before I buy one because I don’t want to get burned,'” Katz said.

Among doctors, the use of technology varied by specialty and by size of practice, according to the medical society’s 2008 survey. Fifteen percent of solo practitioners reported using electronic medical records, compared with 44 percent of physicians in large groups. And in Connecticut, unlike many other states, the majority of doctors work in groups with four doctors or fewer.

Connecticut also has an older medical workforce than most states, with the majority of doctors over 50.

“Many of them are close to retirement and they’re thinking, ‘well, I’m going to retire in 5 years, do I really want to spend $50,000 in my practice when margins are already thin?'” Katz said.

Other doctors are waiting for costs to go down or to see how much their colleagues get paid by the federal government for using the systems.

“I think there’s still a fair amount of skepticism on the part of physicians about whether or not it’s going to happen, number one, and then also trying to justify an investment,” said Douglas S. Arnold, executive director of Medical Professional Services, an independent physician association that includes more than 400 Connecticut doctors.

Arnold noted that Medicare rates are set to drop substantially at the end of the year, leaving many doctors skeptical that incentive money attached to Medicare will be worthwhile.

Commercial insurers are starting to offer incentives for providers using electronic systems, which Arnold said could be a key step toward getting more doctors on board.

“When the public and private payers all start saying ‘we’re going to provide incentives for the adoption of health information technology,’ I think that’s going to be a pretty substantial tipping point,” he said.

Eager to usher in changes, Congress included in the 2009 stimulus bill $27 billion in payments over 10 years, starting in 2011, to Medicare and Medicaid providers who adopt EMRs.

But to be eligible for the money, providers have to meet certain federal criteria, known as “meaningful use.” One requirement is being able to share information with other providers’ systems electronically – a key element that many electronic systems lack.

Come 2015, the federal government will impose penalties, in the form of reduced reimbursements, if providers do not meet key yardsticks, which will evolve with time.

Connecticut hospitals are at varying stages in implementing health information technology systems, said John Brady, chief financial officer and vice president of business development at the Connecticut Hospital Association. But hospitals don’t see meeting the federal requirements as a matter of choice.

“The financial incentives and then penalties laid out in the rule make it so that it’s clear that hospitals need to do this,” he said.

Some hospitals in Connecticut will be ready to capture federal money as soon as it is released. Others will need more time, but most will be able to achieve meaningful use within the timeframe the federal government established, he said.

Achieving meaningful use will require changes in how hospitals operate, not just adding technology. One requirement, for example, calls for entering a certain percentage of patient orders electronically.

“There’s an IT project aspect to all of this, and to date, most of the work has been in IT,” Brady said. “However, there are significant operational issues and impacts to the utilization of the information technology that will prove to be just as time-consuming, if not more so, than the actual getting the systems upgraded and up and running.”

Jha said a lag is understandable. For one thing, because the U.S. system works on a “fee-for-service” basis, hospitals get reimbursed for performing tests and procedures, even if a patient has recently had those tests done somewhere else. The fact that another round of tests does not bring any new benefit to the patient doesn’t matter.

“The hospital doesn’t see it as a revenue loss,” Jha said. An expensive new IT system, though, is seen as a major revenue loss, with both an initial outlay to buy the system and the disruption required to put it in and training staff already working in “a very busy and very high-risk environment,” he said.

For doctors, putting money into technology programs can seem like spending money on changes that will primarily help insurance companies, Arnold said, since insurers stand to gain from efficiencies.

“There are a lot of structural issues in the whole health care milieu that are arguing against massive adoption of health care information technology,” he said.

Ultimately, Katz believes there will be a time when all doctors will be using electronic systems – if not electronic medical records, then disease registries and systems that help them track aspects of patient care.

“I don’t think that time is tomorrow,” he said. “I don’t think that time is in two years. I think that you will see within three to five years the vast majority of practices having health information technology.”

Installing new software alone will not transform the health care system, Jha said. Instead, along with the electronic systems must come fundamental changes that move health care from a fee-for-service system to one that rewards outcomes, treating patients in a more holistic fashion, something electronic records enable.

“Right now, doctors get paid to do more, not necessarily to do better,” he said.  But, he said, “If all of a sudden you were required to take care of the whole patient and all of his or her health care needs, doing that in a paper-based world is very difficult because you just won’t have the information you need.”

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Arielle Levin Becker

SEE WHAT READERS SAID

RELATED STORIES
Miguel Cardona’s ideas about education were forged in Meriden, CT. Now he will bring them to Washington, D.C.
by Jacqueline Rabe Thomas and Adria Watson

Miguel Cardona's experiences in Meriden will likely be front-of-mind as he coordinates policy as U.S. Secretary of Education.

State Rep. Scanlon launches tax fairness debate with proposed $450M break for poor, middle class families
by Keith M. Phaneuf

A new proposal Tuesday would give middle class families with children their largest state income tax break in a decade.

Treason is in the air
by David Holahan

Abraham Lincoln had been elected but had yet to assume the presidency when southern states started seceding from the Union in the months before his March 4, 1961 inauguration. Four others would follow that spring. American soldiers —like Robert E. Lee, who had taken an oath of loyalty to the nation that he had served since 1825— defected to the Confederacy. By joining the rebellion Lee and fellow travellers became, in effect, traitors.

The change in leadership must not lead to complacency
by Jenna Van Donselaar

We are beginning 2021, and most people are far done with election talk. Sure, the polls are closed, and the results are in, and it is time to move on. I am weary from the hours I spent texting voters this fall, and I’d like to think all my efforts were worth it. But the work is far from done.

Trump’s reaction to defeat further confirms urgency for school focus on social emotional skills 
by Sandra M. Chafouleas 

Imagine what would happen if a preschooler didn’t “use their words” when they got upset about sharing, instead stomping around yelling while adults simply observed in silence. Think about what the school climate would feel like if a student punched another during recess while others watched without seeking help.  Now consider the actions – and inactions – by Trump Jan. 6 as the electoral vote counts occurred at the U.S. Capitol.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion The change in leadership must not lead to complacency
by Jenna Van Donselaar

We are beginning 2021, and most people are far done with election talk. Sure, the polls are closed, and the results are in, and it is time to move on. I am weary from the hours I spent texting voters this fall, and I’d like to think all my efforts were worth it. But the work is far from done.

Opinion Treason is in the air
by David Holahan

Abraham Lincoln had been elected but had yet to assume the presidency when southern states started seceding from the Union in the months before his March 4, 1961 inauguration. Four others would follow that spring. American soldiers —like Robert E. Lee, who had taken an oath of loyalty to the nation that he had served since 1825— defected to the Confederacy. By joining the rebellion Lee and fellow travellers became, in effect, traitors.

Opinion Trump’s reaction to defeat further confirms urgency for school focus on social emotional skills 
by Sandra M. Chafouleas 

Imagine what would happen if a preschooler didn’t “use their words” when they got upset about sharing, instead stomping around yelling while adults simply observed in silence. Think about what the school climate would feel like if a student punched another during recess while others watched without seeking help.  Now consider the actions – and inactions – by Trump Jan. 6 as the electoral vote counts occurred at the U.S. Capitol.

Opinion Is Trump leading a cult?
by Elena Sada

My experience as a former cult member and researcher in the field of Social Sciences earned me the ability to identify narcissism and cultish tendencies. Furthermore, as a former  New York City resident who kept abreast of interviews with the city’s apparent “movers and shakers,” I often questioned Trump’s qualifications as a leader, let alone as national presidential leader.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO