Cost of going electronic concerns some doctors

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.