« I'll Order My TV Programming from the A La Carte Menu, Thank You Very Much | Main | If Only More TV Characters Were Bloggers »
February 10, 2006
Will a Medical Digital Divide Hasten the Extinction of the Neighborhood Medical Practice?
Today's Boston Globe has an interesting story about the large number of doctors who still can't afford to digitize their patients' medical records. This is creating a performance gap between digital and analog medical offices: computerized records allow doctors to monitor their patients' health and file their insurance claims more effectively.
Nationally, the state is in the vanguard of electronic medical record keeping -- not surprising given the high concentration of teaching hospitals and medical technology. But most of the computerization of records is being done by large physician organizations with more resources, creating a widening technology gap in the medical community.Physicians who use computers can monitor patients' care more efficiently and reduce the possibility of medical errors. As a result, they consistently score better in quality surveys. Moreover, they earn 3 to 4 percent more money in ''pay-for-performance" contracts with health insurance companies.
According to the article, 20 to 25 percent of the 30,000 doctors in Massachusetts utilize electronic medical records or an electronic medication prescription system. Additionally, many of these digital offices are part of large academic medical networks, suggesting that smaller medical practices are even less likely to have an e-records system. And Massachusetts is ahead of the game - only 10 to 15 percent of doctors nationally use computerized record keeping.
It's more than just keeping lots of insurance paperwork in order; patient e-records contribute to more attentive and effective treatment.
The clinical benefits of computerized records are clear to advocates, especially when it comes to primary care. Not only do the systems automatically warn doctors about dangerous drug interactions or allergies, but physicians can review medical tests online, send out reminders to patients to get tests and checkups, and monitor the health of patients with similar diseases. The systems also allow them to better focus on patients who are the sickest and to control factors like diet, weight, and medications.
Unfortunately, doctors can't simply invest in a Dell laptop or a Mac Mini and call it a day - these e-record systems can cost tens of thousands of dollars. This makes it harder for smaller practices to remain independent. ''It's going to be very difficult for individual physicians to function as small independent practitioners in this environment," says Dr. James F.X. Kenealy, an ear, nose, and throat specialist in Framingham, west of Boston. ''You are going to see over time an amalgamation of individual physicians into groups."
In recent years we've already seen the Walmartification of the medical profession, in which large, monolithic medical networks replace the small, more intimate mom 'n pop practices. As it becomes clearer that expensive e-records systems are absolutely necessary for maintaining a strong, effective practice, will the individual family practitioner go the way of the dodo? -andy
Posted by acarvin at February 10, 2006 9:38 AM
Listen to a computer-generated podcast of this article
