Physicians, in my opinion, have the most important job in the Healthcare system. They make decisions every day on diagnosis and treatments for patients. They are required to complete college, Medical School, and Internship/Residency. For Primary care, this is 11-12 years of education after High School in a very competitive environment. Additionally, Physicians attend Continuing Medical Education (CME) events to further their depth of knowledge.
My wife, a board certified Pediatrician, recently attended a CME event on the Medical Home. During the 4+ hour CME event, topics related to Health IT were raised. Since I am so ‘buried’ in HealthIT, I lose perspective of the importance of discussing some of the common questions and misperceptions. Listed below are a few of these misperceptions that occurred at this CME Event:
- One of the attendees whom achieved Medical level III certification (impressive) for their practice still does not utilize an E.H.R. (They do all the follow-up/tracking via paper!). Their practice is moving to the same system as the hospital because they were led to believe that interoperability is best when using the same computer system as the Hospital. There was no discussion/ understanding that future Health Exchanges will allow providers to exchange information with multiple hospitals, labs, other providers, etc. This means that all a practice needs to do is use an ONC-ATCB Certified Product E.H.R., e.g. PhysicianXpress, to connect their practice to a Health Exchanges. This Pediatric practice made a good decision for the hospital but not necessary their practice.
- One of the speakers explained that there are two types of systems, server based and web-based. She stated that their system was server based and raised the concern if the internet is unavailable a practice would not be able to access a web based product. She also brought the obstacle to insure the company has enough technology people available to support the practice (Their practice purchased client-server system years ago which requires IT support individuals on staff). The speaker, unfortunately, provided some misinformation (might be due to the confusing or incorrect information available). The speaker, whom practices in a large multi-specialty group, did not understand that if the ‘internet goes down’ she has the same problem as a web-based EHR since their server-based E.H.R. is located in a different location than her office where she sees patients. Additionally, all server based systems need the internet to send e-Prescriptions, check formulary information, conduct eligibility, lab orders as well as other interoperability links. This means this physician, with a client-server system, is dependent on the Internet to access her patient records, send prescriptions, etc (similiar to a web-based E.H.R.). Additionally, their practice needs to pay for the cost of redundancies, IT support (IT employees of the multi-specialty group or contract an external company), and maintenance of connections. With cloud-based technology, a practice only needs to maintain an internet connection; they can carry an IPad or similar device that runs off a 3G or 4G network as back up. Like a server based system, both cloud-based technology and server based systems need the internet to send Electronic Prescriptions, connect with multiple offices, send laboratory orders, etc. Unlike server based-systems, a practice does not need a ‘high-level’ IT professional on staff (or as a consultant) for the practice (additional cost to the practice).