Electronic medical records and other IT upgrades are seen as a “silver bullet” in the health industry’s struggle against rising costs and quality problems, but high startup expenses are creating a growing divide between big industry players and small practices, said the keynote speaker of a healthcare IT conference hosted by the Massachusetts Health Data Consortium last week.

Fewer than one in four doctors nationwide have begun using electronic health records (EHR), and most who are using electronic records have done only a partial implementation, said John Glaser, vice president and CIO of the Massachusetts hospital chain Partners HealthCare System.

Meanwhile, the Mayo Clinic is taking a lead role in electronic medical records and large corporations such as Wal-Mart are providing their employees with personal health records (PHR), which let patients log onto the Web and view medical information such as test results and instructions for taking medication. Promoters of personal health records say they let patients make better decisions related to their care, but people who go to small medical practices may be left out.

Click to see: Doctors slow to adopt electronic health records

“We’ve got a divide now and it’s going to get worse in the years ahead,” Glaser said.

Many people believe that IT is the answer to problems ailing the health industry, and Glaser counts himself among them. But he said people have unrealistic expectations for IT because all previous approaches to containing cost and maintaining quality have failed.

“We ought to be real about this,” he said. The transition “will not be orderly. It will be chaotic.”

The U.S. government has made the promotion of electronic medical records and personal health records an official goal. On its Web site, the U.S. Department of Health and Human Services says that because deploying electronic records is costly for smaller practices, the expense must be shared by clinicians and others in the healthcare system.

Access to electronic medical records must be increased in rural and underserved areas, in particular, government health officials say. Regional collaboration among healthcare entities in the form of regional health information organizations can help make patient information easily transferable from one physician to another, they say.

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