US Makes New Push on E-Health Records

By KEVIN FREKING, AP
Mon Oct 29, 8:54 PM EDT
WASHINGTON —
The Bush administration is recruiting about 1,200 doctors nationally to remove the paperwork from their medical practice in return for higher Medicare payments.

Health and Human Services Secretary Mike Leavitt billed the project Monday as one of the administration's most important steps yet toward meeting President Bush's goal of nationwide adoption of electronic health records by 2014.

Medicare will pay the physicians extra for completing tasks online, such as when ordering prescriptions or recording the results of lab tests. The highest payments will go to those physicians who most aggressively use the technology and who score the highest in an annual evaluation.

Many health analysts believe widespread use of electronic health records will reduce medical errors and could potentially slow soaring health care expenses. Yet, only about 10 percent of doctors in solo or small-group practices use such records. Upfront costs for putting in place such computer systems can range from $20,000 to $40,000.

Many doctors see the records as helping insurance companies or patients, but don't believe the upfront investment is worth the hassle, Leavitt said.

"They are saying: 'Look, what's in this for me? My practice is working OK as it is. I need to have some benefit,' Leavitt said. "And they are right."

Officials say the program won't result in a net increase in federal spending. That's because improved care and a greater focus on prevention should make up for the initial investment paid to the doctors.

Participating doctors could see their reimbursements increase by several thousand dollars annually when they treat Medicare patients. The administration has also contacted insurance companies and asked them to consider similar rate increases for participating physicians. That way, doctors would have more incentive to participate.

Several bills have been introduced in Congress to speed adoption of electronic record keeping, but lawmakers have been unable to reach agreement on many key issues, namely the scope of the federal government's role in paying for startup costs.

Dr. Joseph Heyman of Amesbury, Mass., said he's used electronic health records since 2001. He paid for it on his own, but it helped that he was just starting his practice and didn't have to go through all the work of transferring records from paper to computer.

Heyman said he spends less on administrative expenses because of his reliance on electronic record keeping. For example, he needs no storage space for charts and no employees to pull charts.

"I have only one employee. I can spend more time with each patient because my overhead is so low," said Heyman, a member of the American Medical Association's Board of Trustees.

Heyman said he can access patient records over the Internet when he's away from the office, and patients can contact him through his Web site.

"I can go look at her chart, I can refill a prescription. I can give her an appointment, almost anything from any place that I am," Heyman said.

But many doctors believe that adopting electronic record keeping is difficult, which is why they often need more financial incentives to make the move, Heyman said.

"It takes a long time to convert. At the beginning, it's very, very slow and it interferes with your work flow," he said.

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