Hospitals reduce cost of electronic medical records

It's generally accepted that replacing paper medical records with electronic ones should reduce errors, and save lives. Yet most doctors' offices still rely on paper records, because converting to an electronic system is costly and complicated.

It can easily cost $60,000 per doctor, if each physician goes it alone, says Dr. John Halamka, CIO of the CareGroup Healthcare System in Boston.

That’s why the physician group affiliated with CareGroup’s Beth Israel Deaconess Medical Center in Boston has begun a $4 million project to help a few hundred doctors upgrade to electronic records. With a shared infrastructure, Halamka says the per-doctor cost will go down to about $25,000, and the hospital and physicians’ group will pay for 85% of each doctor’s implementation costs.

“Doctors’ offices are a big sea of paper,” Halamka says, explaining why “for the first time, hospitals are becoming IT providers for … community doctors.”

A large majority of medical records are already electronic in the four Caregroup hospitals that Halamka oversees. The three-year-project, which will begin with pilot sites in the first half of this year, focuses on about 300 doctors who are affiliated with the Beth Israel physician group and are spread through Massachusetts, Rhode Island and Maine.

These doctors are still in the paper-based world, as are most of their peers. Less than a quarter of physicians nationwide reported using any kind of electronic medical records in U.S. government survey results released in 2006. Only 9% of doctors nationwide used a complete electronic medical records system, comprised of computerized orders for prescriptions, computerized orders for tests, reporting of test results, and physician notes.

Beth Israel is partnering with Concordant, a vendor that will help build and manage the electronic records infrastructure, delivered to doctors via their Web browsers. Concordant will run the application, hosted on servers in a co-location facility in Marlborough, Mass., and provide desktop support to doctors.

With a centralized infrastructure, a single doctor’s office won’t need to buy its own servers or manage Oracle
databases, Halamka says. They’ll just access the records system on the Web, while Beth Israel and Concordant provided the application and a step-by-step guide on how to convert paper records into electronic ones.

“It’s like a Starbucks model,” Halamka says. “Do you think Starbucks hires a new contractor every time they build a new store?”

Beth Israel is just one of many multi-hospital systems working on electronic medical records. Government pressure and potential regulations will certainly spur larger-scale efforts to go electronic over the next decade, says Dr. Tom Karson, chief medical information officer at Continuum Health Partners in New York. President Bush has stated that every American should have a personal electronic medical record by 2014.

The need to safeguard patient privacy is one major roadblock that could delay such a lofty goal, and is something Continuum and its five hospitals took seriously over the past several years as they rolled out electronic records.