A health IT reality check

I canceled my last vendor meeting at HIMSS09 yesterday so I could make a last-minute doctor’s appointment at 1:15 p.m. (ah, the joys of not having to travel for a major conference). As it turned out, I slogged through most of HIMSS with bronchitis. I hope I didn’t get anyone else sick.

My regular internist is not in this particular office on Wednesdays, so I was seen by another partner in the five-physician primary care practice—the most tech-savvy one. The entire patient-physician encounter lasted the usual 10 minutes, but I got a wonderful demonstration in that short time of the issues facing so many practices.

The doctor pulled up my record on the Sage Intergy EMR that the practice has had for the last three years (a replacement for an earlier system), but couldn’t find much of a history on me. I had given my regular physician a printed list of my medications and allergies the last time I was in there for a checkup last year, but that never got into my electronic chart. No matter, this doctor took my information verbally, and typed everything in as I was talking to him. (I checked, and it was accurate.)

He examined me, entered the diagnosis into the EMR and gave me some simple, verbal instructions, since he didn’t write any prescriptions for this encounter. (Even I know that antibiotics are ineffective against viral bronchitis, so I picked up some OTC medicine for sore throat and cough at a local Walgreens.)

I was surprised my history hadn’t gotten into the record, but this doctor was not. He is what you could call an early adopter, having been convinced to go electronic a decade ago. He said he’s been fighting his partners for years to get them to use the EMR for more than just entering orders and diagnoses. He said he loves the Intergy system, which should make the folks in Tampa smile, but wishes he could persuade the other doctors to do more and make a larger investment.

This practice has spent $120,000 over the past three years on the EMR, but needs another $50,000 to integrate or upgrade the practice management system so the two sides could share demographic and insurance data, making the whole operation more efficient. Unfortunately, the other doctors don’t want to spend the extra money while primary care is under so much financial pressure. Until there is the link between practice management and EMR, the practice isn’t even able to report its activity to capture the new 2% Medicare bonus for e-prescribing, the doctor said.

All the stimulus money sounds exciting for those of us who view health IT from on high, but January 2011 might as well be an eternity from now for those on the front lines of medicine.