Surveys aside, the stories about physicians implementing EHRs as reported in local media are incredibly instructive in understanding what's happening out in the field with EHR adoption. I read about a family practice physician in a two-physician office in Mount Pleasant, Tex. His insights are quite interesting, and I encourage you to read the article.
To put things in perspective, Dr. Paul Meriwether has been practicing family medicine for 25 years and his partner has been practicing for 30 years. Meriwether discussed the healthcare reform impact, but I'm going to stick to the health IT aspect. The office began working on it health IT transformation a little more than a year ago. Rather than do a big-bang implementation, the office opted for a phased approach with the software applications because of the complexity of the changes.
Meriwether has experienced the usual impacts of implementing an EHR system - decreased volume of patients, steep learning curve, upfront cost of hardware and software, and hiring of two FTEs and one part-time employee. Billing workflow required changes in order to integrate its billing system with the clinical information system.
Things are getting better as the office gets its workflow running smoothly, but it's come after the office experienced a 30 to 50 percent decrease in patient volume (ouch), which meant restricting appointments and limiting the number of patient they could see.
The office's current Medicare load is about 25 percent. How much that percent increases will be viewed on a patient-by-patient case, he said. Being in business for 25 years means he has long-time patients, but they will still need to be treated as new patients when it comes to creating and gathering patient data, which is where a bulk of time and resources is devoted.
He was forewarned and therefore anticipated the initial hardships. Meriwether expects to be back to normal capacity in another six months, saying "it's going to get better." He called the changes "a necessary inconvenience toward a positive end."
Meriwether's whole attitude seems to reflect an acceptance of a new transformation and an understanding that this is for the good. Whether he felt this way before making the decision to implement may be another story. Who knows if where he is today with his feelings on health IT was also an evolution, just as his office is evolving.
His comments - that health IT is part of the evolution of healthcare, something that needs to be done, akin to past transformations that were introduced and had becomes second nature and part of the profession, and something physicians entering the field expect to use in their practice of medicine - all point to an attitude that this is where the healthcare industry is moving, which is what David Blumenthal, MD, head of ONC, is hoping becomes viral.
Photo by NASA Goddard Photo and Video courtesy of Creative Commons license.
