Many physician champions tout EHRs as an enabler for delivering quality care anywhere. Nova Scotia apparently is not full of physician champions.
The province was aiming for 100 percent buy-in from its 2,000 physicians, which include primary care and specialists, by 2012. While they don't have an equivalent meaningful use requirement, the government subsidizes the cost of a system with a lump sum of $5,300 and maintenance cost subsidies. Nevertheless, their goal won't be met because only 33 percent of primary care physicians have EHRs and few specialists have implemented systems.
The usual barriers of cost and technical snafus were cited. One physician champion practicing in Nova Scotia simply said the physicians are set in their ways. That comment begged the question: What are the demographics of the physicians in Nova Scotia? While I couldn't find the answer to that question easily, I did find overall data points that likely support the notion that physicians don’t want to transition from paper to electronic patient records.
According to the Canadian Institute for Health Information (CIHI), the average age of specialists in the country in 2008 was 50.6. For family medicine, the average age was 49 years old in 2008, compared to 43.4 in 1978. CIHI also noted that while the number of active physicians in Canada grew by 4.3 percent, the majority of physicians age 70 to 79 in 2004 were still practicing in 2008. So it would seem that there is an older physician workforce currently in Canada, though with the grow in numbers it also means there is growth in the younger physicians entering the market.
Not to generalize, but anecdotally it seems that the older generation of physicians don't want to change their workflow practices, which is understandable when they've been operating for decades in a certain manner. Physicians in their 50s and 60s, however, will likely be still in practice 10 or 15 years later, if the trend of physician growth stays steady. Ten or 15 years is a long time to not change one's workflow.
It may very well take the younger physicians to lead the way - as well as the veterans who have become physician champions. If having a thriving practice is a priority, and the younger physicians are embracing health IT, these older physicians may find that David Blumenthal, MD, head of the U.S.'s ONC may be onto something: Adopting the meaningful use of health IT will become a part of the profession.
Photo by Bob Jagendorf courtesy of Creative Commons license.
