President-Elect Urges Electronic Medical Records in 5 Years

But many doctors have been reticent to even adopt the technology that is currently available. In a 2008 article published in the New England Journal of Medicine, researchers led by Dr. Catherine DesRoches of Harvard Medical School found that 17 percent of doctors currently use electronic medical records.

One significant barrier to attaining a universal electronic health records system could be cost. Physicians may be required to foot a bill of tens and thousands of dollars to invest in such a system for their offices, not to mention steep annual maintenance fees.

For larger practices with more physicians, the additional cost may not pose much of a problem. But for an office with fewer than 10 or so physicians, electronic medical records may seem impractical and expensive.

"I think the primary issue is cost, specifically capital investment, as well as decreased productivity during the changeover," said Dr. Thomas Schwenk, chairman of family medicine at the University of Michigan. "It is estimated to take many months, possibly even a year, to get back to previous level of productivity in the office when switching from paper to [electronic medical records]."

The learning curve is another issue.

"There is a well-known lack of skilled personnel to properly implement and sustain these systems, and that experience does not come easily," said Dr. Lyle Berkowitz, medical director of clinical information systems at the Northwestern Memorial Physicians Group in Chicago.

Berkowitz argued that physicians are not sufficiently reimbursed for the time, energy and money required to adopt an electronic medical records system. The known benefits of switching to an electronic system -- such as less duplication of tests and more preventive care -- are enjoyed primarily by insurance companies, patients and employers rather than physicians, he said.

"In other words, to implement ... an EMR effectively, a physician will likely lose money and not get reimbursed for more effective or higher quality of care," Berkowitz said.

Crounse said that it is little surprise that few doctors -- particularly primary care doctors -- are stepping forward to invest what he says could be $25,000 in a system for electronic medical records.

"We're asking them to step up and spend a lot of money on electronic medical records. The doctors will say that a lot of the benefits of these systems accrue to everyone but the doctor."

While he said that the benefits for doctors are there -- primarily in the form of improved patient safety and care -- this perception could give many doctors pause.

Keeping the Lid on Medical Information

With the novelty of electronic health records also comes new questions about how to keep the information private and secure. Particularly concerning to some is that many of the records may be stored on the Internet.

The architects of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) -- more or less the law of the land when it comes to patient privacy -- did not anticipate Web-based health record systems so they have nothing in their act that regulates Web data handling and patient privacy.

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