As recently reported in the New England Journal of Medicine only 4% of doctors in the US have a fully functional electronic records system and most of those are in massive group practices. With the supposed benefits and battle cries for patient centric care one would assume that the demand would be greater and the adaptation quicker.
To my eye the demand is not there yet;
- In my own practice fewer than 5% of referrals are electronic, 1/20 patients provide an email address and 1/50 list it as their preferred method of contact (all are offered). It is hardly an overwhelming demand for electronic communication.
- When done well, efficiency does not change and if implemented poorly it can lower productivity.
- The cost of installation can easily reach $10,000 per seat and the maintenance fees $1,000 per year per seat.
So why switch?
- There is less chance for error especially with follow-up such as with labs, other tests, referrals and preventive care. With EMR the chance of forgetting certain items drops to nearly zero.
- Increased capacity. Even though productivity can drop in a poorly implemented system, (e.g. daily billings) capacity increases by eliminating repeated or unnecessary work. In our office we saw an 18% improvement in capacity the first year and 6% the next.
Most physicians that participated in the survey also stated they planned to make the switch soon. Improved networks, a greater emphasis on efficiency by programmers, government incentives and diminishing cost for wide bandwidth will all make the transition easier and not too far in the future.