Docs Consider Switch to Elecronic Medical Records

Doctors and nurses from Florida Gulf Coast University’s Student Health Services stare at computer screens. They’re training to use their new electronic medical record system or EMR. A representative from the EMR company goes over its features on a projector.

They soon realize they’re dealing with a whole new way of doing things – even the smallest of things.

Medical Director Dr. Kevin Collins and others try to standardize how nurses should “sign” the ‘nurses note’ now that they cannot physically sign it.

F-G-C-U’s Student Health Services is just one of a growing number of physician practices, clinics, and hospitals switching to electronic medical records.

“It is what every physician in the country is going to do eventually,” said Dr. Collins. “This seemed like the right time to do it.”

Last year, the federal government passed the HITECH Act, pushing physicians to adopt the EMR. It allocated 27 billion dollars to help fund the switch – creating an incentive for doctors and hospitals to do it. By 2015, those without electronic records will be financially penalized by getting less money for Medicare reimbursements.

Going electronic can help physicians avoid duplications of tests. It can alert them to drug interactions before writing new prescriptions. And it can allow health systems to easily track public health data and trends.

But only twenty percent of doctors and ten percent of hospitals have made the switch.

“It’s difficult to make that layout when you’re not sure what the return on that investment is going to be,” says Dr. Jon Burdzy. “$25,000 is difficult for many small practices to come up with.”

Burdzy has used electronic records in his solo family practice in Fort Myers for almost four years. The switch was expensive and initially slowed down his practice.

“It really cut down the number of patients we were able to see as we were learning to use this,” he says. “It probably took about a year for us to get comfortable with the system.”

And it took one year to return to the normal number of patients seen each day.

But Burdzy says it has saved him money when it comes to sending records to other physicians. He does see the benefit and believes it has helped him provide better care to his patients.

However, he is not sure how much time it saves him—or the doctors he works with.

Dr. Pat Fitzgerald uses paper records in his solo family practice in Fort Myers and he covers patients in the hospital with Dr. Burdzy. He goes over a consulting letter for a patient sent from a doctor who uses electronic records. With paper records, they’re usually less than one page long.

With electronic records, he counts four pages of notes from one patient’s visit to the doctor.

Fitzgerald believes the EMR collects tons of information – most of which is redundant.

“You’ve got this mass of uncoordinated data,” he says. “Even though it’s all there it’s agonizing to try and go through this information, so you become inefficient.”

Although Fitzgerald sees its benefits and potential, he says the EMR is not quite ready. It needs more time to work out the kinks.

The ultimate vision with going electronic is one record that travels with each patient wherever they go for healthcare. Such a system has been used by Veterans Affairs clinics and hospitals for years. However with no national standardization and more than 100 different EMR systems, many wonder how that would work everywhere else.

On a small scale, Southwest Florida’s Lee Memorial Health System hopes to make that a reality for the area it serves.

“What we’re trying to do is have one seamless patient record throughout the community,” says Lee Memorial Health System Chief Information Officer Mike Smith.

Lee Memorial has been using electronic records for 10 years, but is in the process of phasing in the next generation. It’s working towards having four hospitals and multiple physicians’ offices running on the same system by the end of 2012. Smith says healthcare is an information business.

“The better information the caregiver has about you and what has done to you and what your history is –the better care they’re going to be able to deliver to you.”

Some patients see the advantage, while others don’t –citing time, security, and experience as their main concerns. Most are ambivalent.

Barbara Journey goes to a doctor who has been using electronic records for two years. She says she hasn’t noticed much of a difference, but adds that she prefers the “old-fashioned” paper record system.

“I rather have you look at me when I’m talking to you, rather than busy with the computer.”

However, there is one advantage everyone can agree on.

“You cannot read the vast majority of doctor’s handwriting,” says Dr. Fitzgerald. “Computers will help with that.”

And some say that alone, may be worth the switch.

Farah Dosani reports for the Healthy State Collaborative, Florida's Guide to a Healthier State of Living.