More Doctors Warm Up To Health IT

April 20, 2008
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LANSING — More Michigan physicians are incorporating computer technology into their practices, according to results of a 2007 survey recently released by the Michigan Department of Community Health.

The survey of doctors who renewed their licenses last year showed that about two-thirds of practices used computers for lab results, X-rays or hospital records. That rate was the same in 2006 and compares to 56 percent in 2005. Far fewer use computer applications such as e-mail or the World Wide Web to communicate with patients: just 16 percent.

Doctors must renew their licenses every three years, so each annual survey reaches about one-third of the state’s 41,785 physicians.

Technology use in medicine is getting more attention in West Michigan as the Alliance for Health, a local health planning agency, has received several grants for establishing a Regional Health Information Exchange and for tracking quality in patient care. Metro Health Hospital and Michigan Medical PC, the area’s largest doctors’ practice, are investing millions of dollars into information technology from Epic Systems Corp. of Wisconsin. Trinity Health, owner of Saint Mary’s Health Care in Grand Rapids and Mercy Health Partners in Muskegon, is rolling out a new electronic medical records system across its hospital system, as well.

But for physician practices, incorporating technology must make sense for the bottom line, said Dr. Paul Ponstein, medical director of the West Shore Health Network based in Muskegon.

“It all has to be paid for,” Ponstein said. “I think that if it was a break-even business case, adoption would be much more rapid. But it’s a negative business case for most physician offices.”

Use of the Web to access hospital portal sites “is high in our community also,” said Ponstein, who is a member of an Alliance for Health committee working on a regional health information exchange plan.

“If you look at electronic health records, we have a couple of early adopters, but just recently is that beginning to take hold,” Ponstein said. “In the small offices, defined as four or under physicians, the adoption rates nationally and in Muskegon County are in the teens. I don’t think that trend is likely to change because of the cost of purchasing, training, implementation and maintaining.”

Dr. Brad Clegg, medical director of clinical informatics at Metro Health Hospital, said the low rate of patient communication via computer is changing. His Cascade Metro Health office in December started using Epic’s application that allows patients access to their medical records, lab results and doctors’ comment. Roll-out begins this week for Metro’s nine other neighborhood medical offices, he said.

“It’s all about quality and patient care and proving you’re doing a good job. Epic has a ton of functionality to tell us how we’re doing, and if we’re not doing well, where and why.”

Electronic medical records are a major change for doctors, said Dr. John Oostendorp, chief medical information officer for MMPC.

“For most physicians, electronic medical records are going to be the most radical change in how they practice medicine in their lives,” Oostendorp said. “Most of us learned our whole work flow and style of work using paper records. This is a very big change for physicians.”

One MMPC site is “going live” on May 1 with Epic’s practice management application for such functions as scheduling, registration and billing, he said. With more than 200 doctors, the programs won’t be fully implemented till August 2009 under the current plan, he added.

“We do believe there are significant patient safety issues when it’s done right,” Oostendorp said. “E-prescribing — the ability to generate prescriptions electronically — allows you to check for drug interactions. I can share information seamlessly with other physicians, so Dr. A knows what Dr. B is doing.”

On other issues in the survey, it showed that of the 5,363 licensed doctors who responded, 35 percent are either not working as physicians or are working outside of the state. A little less than two-thirds, 62 percent, provide patient care. Three percent are working as doctors in Michigan, but don’t provide patient care.

Retirement plans are ahead within one to 10 years for 41 percent of active physicians in 2007, compared to 34 percent in 2006 and 38 percent in 2005. Age is the biggest reason for retirement, but they also list administrative and regulatory burden, inadequate reimbursement, malpractice insurance cost, lifestyle and lack of job satisfaction.

Sixty-one percent said their patient load is full or nearly full with the capacity for only a few more patients. Eighty-seven percent say they serve Medicaid patients, and 91 percent serve Medicare patients.

Of those active in the state, 36 percent said they are primary care physicians, and 73 percent have a specialty outside of primary care.

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