Cost of going electronic concerns some doctors

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It cost Augusta Heart Associates more than $200,000 to implement electronic medical records and several months of overtime to get employees to input old charts. But cardiologist Mac Bowman said he worries a lot of doctors won't be able to follow suit.

At a University Hospital board meeting Thursday, Dr. Bowman and partner Michael Holman said it takes considerable resources to implement electronic records.

"It's a big undertaking," Dr. Holman said.

Only 17 percent of physicians use even basic electronic records, according to a study published online Thursday in the New England Journal of Medicine . The federal stimulus plan set aside $19 billion to help promote and implement electronic health records. The goal is for everyone to have an electronic medical record by 2014.

But the money won't begin flowing until 2011 and then will go only to those who make "meaningful use" of electronic records, said J. Larry Read, the CEO of University Health Care System.

"That criteria has yet to be defined," he said, though a definition is expected by the end of the year.

Though less than 2 percent of U.S. hospitals are fully automated, according to the New England Journal article, many, such as University, are well on their way. Those facilities will receive a $2 million bonus payment plus extra Medicare reimbursement for adopting and using electronic health records, starting in 2011.

"It looks like an excellent opportunity for us and we're off to a good start," Mr. Read said. It will take several million dollars, however, to be compliant, and it will cost the average physician about $47,000 to get automated, Mr. Read said.

How the hospital system will cooperate with physician offices such as Augusta Heart Associates, or with other hospitals, is also still an open question.

"That is going to be key," Dr. Bowman said.

The new system allows Augusta Heart Associates to save money on transcription, for instance, and to e-mail prescriptions directly to pharmacies.

"It's neat: You just pull all of their stuff up and you've got all of the records there and all of the reports, all right there on your laptop," Dr. Bowman said.

It's hard to pin down whether it has led to any significant savings yet. That could change in 2011, when incentive payments for "meaningful use" kick in. That could be as much $18,000 the first year, with slightly reduced payments in succeeding years, with some earning $44,000 over a five-year period, according to an article in the New England Journal of Medicine .

Those that do not adopt electronic records by 2015 could face Medicare cuts of 1 percent, then 2 percent and 3 percent in succeeding years, according to the study.

"There's a carrot and a stick involved in that," Mr. Read said.

There might have to be some kind of lease program or some incentives to help those who can't afford the big initial cost, Dr. Bowman said, particularly for primary care doctors who are already facing significant challenges.

"That's what you worry about," he said. "A lot of guys will just tell you, 'Right now I'm having trouble paying my staff and my malpractice (insurance premiums). I just can't do that.' "

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

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momofthree
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momofthree 03/27/09 - 07:49 am
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It cost 200K staart up and in

It cost 200K staart up and in the long run it will save much more. A paperless system greatly reduces the operating costs, storage costs, shreadding costs. Most of the money invested can be regained in less than 2 years.

robaroo
745
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robaroo 03/27/09 - 08:47 am
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It's something that has to

It's something that has to happen. But ...
Cyber criminals are out there looking for personal information. The hospitals need to make sure records are encrypted when not in use. Dr. Bowman can get sued for malpractice if somebody steals that laptop and private patient information is on it unencrypted.

soldout
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soldout 03/27/09 - 09:15 am
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We have made medical care far

We have made medical care far too complicated from insurance, privacy, record keeping etc. It is becoming like school and the "main thing" is no longer the "main thing". All these type problems will be fixed an individuals become more involved in the outcome of their own lives. This is done through self-education. You see this in home schooling, online learning, alternative health care, self taught health care, raising your own food, repairing your own products, creating your own electricity etc. Stay teachable and productive everyday. Cut off the TV and let the rest of the world become socialistic and dependent on the "village" to care for them while you have the joy and peace of an independent life only needing the leadereship of the Holy Spirit.

Debster
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Debster 03/27/09 - 09:16 am
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My pediatrician has gone

My pediatrician has gone completely electronic ... from patient charts to prescriptions. Prior to his transition to the paperless system, I could call and talk with a nurse about my child's illness. Recently, he sent out a newsletter that said if you need to be on the phone with the nurse for more than a few minutes, you will be billed. While electronic is good believe me, the patients are paying for it.

politicallyNcorrect1
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politicallyNcorrect1 03/27/09 - 09:31 am
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The people hired to input the

The people hired to input the records into the pc's, are they the ones that got the job as a low bid? This is your/our lives they are inputting. how many will die because of a type-o? Anyone think of this?

politicallyNcorrect1
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politicallyNcorrect1 03/27/09 - 09:33 am
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Nurse: Sir your leg can not

Nurse: Sir your leg can not be broke our records state you don't have a leg...to stand on...lol

APiratesLife4Me
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APiratesLife4Me 03/27/09 - 10:52 am
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Glad to see my Cardiologist

Glad to see my Cardiologist is on top of the latest technology. Dr. Bowman is one of, if not the best Cardiologist in Augusta.

jack
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jack 03/27/09 - 12:48 pm
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My fear is that electronic,

My fear is that electronic, centralized health records in a government computer system will be used to ration health care under BimbObama's socialized medicine.

iletuknow
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iletuknow 03/27/09 - 12:58 pm
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They don't seem to mind

They don't seem to mind typing out numerous prescriptions in which they get generous kickbacks!
How about making public how many times they have been sued for malpractice suits and reprimanded for unsavory actions?

williamhitt
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williamhitt 03/27/09 - 01:53 pm
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I had a private medical

I had a private medical office for 41 years. I would not be able to afford electronic records if I still had a practice. I also have a BS in Pharmacy and before and during medical school I practiced pharmacy in Augusta. I have never known a pharmacist or a physician to participate in kickbacks. I have known physicians and pharmacists who violated other laws.

iletuknow
8
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iletuknow 03/27/09 - 02:26 pm
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All expenses paid junkets at

All expenses paid junkets at expensive resorts paid for by the pharmacetucal industry are well known.

Fiat_Lux
15420
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Fiat_Lux 03/27/09 - 04:05 pm
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And if the power grid has a

And if the power grid has a meltdown, wonder what the back-up plan is. It might be a good idea for every individual to have a hardcopy backup of their own medical record. It's already something of a mess for patients with multiple caregivers not really being coordinated in their care. Electronic records are supposed to be the answer to that, but...

corgimom
32363
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corgimom 03/27/09 - 06:06 pm
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You do not own your medical

You do not own your medical records, so you will only receive a copy at the doctor's/care facilities' discretion. It is the property of the doctor/care facility. Medicare is automated, and it's fine. Getting claims paid is much easier than it was in years past. The only problems I have with electronic Medicare claims have originiated at doctor's offices. Electronic prescriptions have built-in backups that do not exist with paper scripts. I trust electronic scripts far more than paper ones.

Junket831
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Junket831 03/27/09 - 11:46 pm
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The advantages of electronic

The advantages of electronic records far outweigh the disadvantages. The potential for errors, particularly with prescriptions, is greatly reduced. Technology can be used to identify trends such as abnormal lab results, x-ray, ekg findings. A physcian and other members of the healthcare team will be able to view information provided by other providers. Relying on faxes and mail is not reliable. A medical provider needs real time information. If the x-ray, lab result or other test or notes are available at the time of consultation or treatment the overall care is vastly improved. Medical practices do not need to convert all old medical records to electronic form. They just need to convert current information and possibly recent tests, findings that will help with the care. As time goes on, the old paper record will become less useful and can be archived.

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