Stimulus money available for doctors to switch to digital records

By Jeremy Twitchell

Thursday, Sept. 3, 2009 | 3:45 p.m.

Improved patient treatment, better security and lower costs — those were just a few of the more tantalizing benefits dangled in front of Las Vegas physicians when a national tour promoting the benefits of switching to electronic health records stopped today at the Renaissance Hotel.

The presentation -- given by a company that provides electronic health records systems and local physicians who have switched to the system -- was meant to instruct caregivers how to take advantage of federal stimulus dollars that can help them offset the cost of switching to an electronic system.

The changeover is by no means an easy process, admitted some physicians and medical office managers who have made the switch. They said it took months, if not years, to fully migrate over, and employee frustration frequently ran high during the process.

Now that the change is complete, however, they swear by the new system.

“(Electronic health records) saved our business,” proclaimed Ernest Barela, former Chief Operating Officer of Fremont Medical Centers and vice president of Health Care Partners, which acquired Fremont in July. The group has several medical centers in the Las Vegas Valley. “They allowed us to stay in operation,” he said.

Barela said that near the beginning of the decade, declining revenues required Fremont’s staff to make a decision: slash salaries and consider layoffs, or change the way it did business.

When the company switched to an electronic record system, it found significant savings from not having to produce paper charts anymore, and with the records storage space it no longer needed, it was able to consolidate its operations and save thousands per month in rent.

The system paid for itself in three months, Barela said.

“We needed to become more efficient, and technology helps you be more efficient,” Barela said.

Russell Suzuki of Certified Health Systems, Nevada’s only licensed provider of Allscripts electronic health records systems, said improving efficiency is just one reason to implement electronic records. Allscripts sponsored the tour.

“For the typical Nevadan, it’s really huge,” Suzuki said. “The basic thing involved in electronic health records is improving patient safety.” Suzuki said the system can drastically cut down on medical errors and costs by taking medical charts, which cost $7 each to produce and are difficult to use, and making them obsolete.

Electronic systems also make it easier for primary care physicians to transmit patient data to surgeons and specialists, he said, allowing for those parties to make more informed decisions and eliminating the need for re-tests that surgeons and specialists frequently have to do because they can’t get a patient’s information.

Dr. Lonnie Hammargren, Nevada’s former lieutenant governor and a retired neurosurgeon, said getting a patient’s information from their primary care provider was always one of the most frustrating parts of his job.

“It’s nearly impossible,” Hammargren said. “It creates a situation where there’s a delay and replication of the tests. It’s very inefficient, and the only hope to change it is to be able to exchange information electronically. … Having the correct information, quickly, solves a lot of problems.”

Though retired, Hammargren said he attended the presentation because he likes to keep up with how the medical industry is changing. He said the primary reason for his retirement was his malpractice insurance rates increasing to $275,000 -- an expense he said he thinks could be reduced as electronic health care records reduce the risk of medical error.

Still, electronic health care systems have their obstacles. In addition to the cost, Barela said, the logistical challenge of making such a drastic change while keeping a busy office fully functional is daunting. Couple that with the natural human fear of change, he said, and it’s understandable why physicians have been slow to embrace electronic records.

The message of the presentation, however, was that now is the time. With the stimulus money being available for $44,000 to $64,000 per office, presenters said, doctors should consider the move soon, before the $46 billion appropriated for the program is exhausted. Also, they said, any doctor office accepting stimulus money will have to prove by 2014 that it is making efficient use of the system, or face fines.

With so many aspects of the program up in the air -- such as how the money will be reimbursed and how “efficient use” will be defined, doctors who use electronic records say physicians may need the five years between now and 2014 in order to become fully accustomed to the system and the expectations for its use.

Dr. Terence Banich of General Surgery Associates said his practice will be moving to an electronic health records system within the next six months. He said he has worked closely with Certified Health Systems to design and build a system tailored to his practice’s needs, but knows it will not be an easy transition.

And while the federal money is nice, Banich said he’s arrived at the point that he would be putting an electronic system in regardless of any financial assistance.

“Patient safety is my concern,” Banich said. “Information transfer, finding available information and yet still protecting the patient’s information is a big part of that.”