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MEDICAL PROVIDERS WEIGH COST OF ELECTRONIC MEDICAL RECORDS

By Amy Riggin/OF THE COMMERCIAL STAFF
Friday, June 5, 2009 11:19 PM CDT

Bradley County Medical Center administrator Harold Mitchell estimates that his rural hospital will need to spend about a half million dollars on technology to be eligible for stimulus money expected to come down the pipeline in fiscal 2011.

“We’re a small, country hospital and small hospitals almost by definition in this country have a much tougher time accessing capital,” Mitchell said. “We have fewer beds, we have fewer patients — that’s the way it is — and there’s nobody in the hardware and software business out there that’s cutting me a deal because I’m a small hospital.

“So it’s going to cost me as much to have an electronic medical record as it costs the big kids.”

While he agrees that electronic medical records can reduce errors — and ultimately health-care costs — the obstacle for Mitchell and others is having to make the initial investment. Reimbursements from federal stimulus dollars will be higher for those who adopt electronic records within the first two years of the U.S. Department of Health and Human Services program, 2011-2012, according to a recent article in Government Technology Magazine.

As part of the adoption, providers have to shop for, purchase, deploy and demonstrate “meaningful use,” a term that has yet to be defined, Mitchell said.

“There are all sorts of unanswered questions out there at this point,” he said. “I think it would be a good thing — I think it would be a real good thing — but I’m not sure how we’re going to get there.”

So far, Bradley County Medical has computerized patient billing, payroll and general accounting, as well as orders and results for lab work.

At Jefferson Regional Medical Center, President and Chief Executive Officer Bob Atkinson said there is “a pretty far developed electronic medical record” in place already.

“But we’re continuing to do that,” he said. “We’ve concentrated on getting electronic medical records for our inpatient and outpatient clients and we’re just now expanding it for electronic medical records that doctors use in their offices.”

He said hospital records are available to doctors online and eventually doctors’ records will be available for the hospital to access.

“We’re really tying the loop,” Atkinson said.

Atkinson said he is “encouraged” by the most recent digital push.

“That will improve the quality of care and the timeliness of care,” he said. “If that information is available then a lot of tests wouldn’t have to be duplicated.”

He also said it would be “a huge way to cut costs.”

Atkinson said eligible applicants can receive stimulus funding over four years starting in fiscal 2011. JRMC is eligible to receive up to $2.5 million.

Atkinson said he would like to see a regional health information network linking patient information among all Southeast Arkansas hospitals.

One of Mitchell’s concerns is that patient privacy could be breached if the records are available to all providers. HHS on April 17 published information providing steps to secure personal health information and establishing “the trigger for when entities must notify that patient data has been compromised.”

“Protecting patient privacy is a top priority and this guidance specifies proactive steps organizations can take to limit the potential harm a breach can cause,” said HHS spokesman Nick Papas.

Dr. Martha Flowers of Pine Bluff questions the need for electronic medical records at all.

“It’s the people behind the computers who make the difference,” she said. “If you have people messing up or not using them properly then they mean nothing.

“If they’re handled correctly they can be an asset for sure but what I’ve seen so far hasn’t convinced me that I need to make that investment yet.”

She expressed concern that it could be the straw that breaks the backs of some private practice physicians.

“Unless you’ve got deep pockets it can be risky,” Flowers said. “They’re just going to run more people out of business.”

Mitchell said he had a conversation with a local physician recently who also was worried about the initial cost.

“He didn’t think he could afford to do this,” Mitchell said. “He was thinking that he was probably going to have to spend $25,000 to 30,000.”

And time is of the essence.

“I think the timeline they have established is really ambitious,” Mitchell said. “But we’ll stumble along here and do all we can... We don’t have any option.

“If we don’t do it they’re going to cut our Medicare reimbursement and since that already is not sufficient to cover the cost of what we’re doing, I just have to find a way.”

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