Desiderio isn’t the only one who would rather stick with a traditional system than take part in medicine’s digital revolution, which would take him months to transition into — and cost plenty. In August, the Centers for Medicare and Medicaid Services released the final battery of rules — known as Stage 2 — for how doctors should use electronic health records (EHR), but some have yet to computerize their offices to any degree at all.
To nudge doctors to make the switch to electronic records, which are said to be more efficient at tracking patient care, the federal government is offering financial incentives, and in 2015, it will penalize physicians who lag behind. To date, around 55 percent of doctors have complied, about on par with the government’s projections. But many well-established physicians are not wild about making the transition.
Jonathan Plotsky, a Rockville internist who has been in practice for 20 years, is sticking with paper for now. He said that over the past year he has met with countless EHR vendors; they would install the required software for about $30,000 and charge $2,000 a month in subscription fees. But Plotsky feels that the software doesn’t do enough to guard against gaps in treatment. For example, an EHR wouldn’t automatically register that a patient of his received a flu shot at another medical office, he said.
Technology has changed most industries in recent years, but many doctors’ offices still run as they have for decades, with receptionists requesting faxed paperwork and physicians leafing through thick manila folders with years of scrawled medical history stapled inside. Medical students may now be accessing textbooks on their iPads, but much of “health care has stubbornly held onto its cabinet and hanging files,” as Health and Human Services Secretary Kathleen Sebelius remarked at a conference last year.
Policymakers sought to breach that technological gap with a 2009 law, part of the anti-recession stimulus package, that aims to increase EHR adoption to 90 percent for physicians by 2019.
Since last year, the government has been offering up to $44,000 over the course of five years in extra Medicare reimbursements — or up to $63,750 through the Medicaid program — to physicians who had become “meaningful users” of certified EHR technology. “Meaningful use” includes such tasks as prescribing medications and inputting lab results electronically into a patient’s e-file.