Computerized Patient Records Program Starts

Medicare has just launched a pilot program to get doctors to computerize their offices. Officials say electronic health records will cure many of the ills of modern medical care, but some doctors are concerned about the loss of privacy for patients, and the cost of computerization.

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This is ALL THINGS CONSIDERED from NPR News. I'm Michele Norris.

Many insurers, employers and policymakers say the cure for high medical costs and frequent medical errors is simple - computerized medical records. Some large doctors' offices are already onboard but most smaller ones are not. Now Medicare officials are hoping a new pilot program while encouraged doctors and hospitals everywhere to make the leap. That way everything about a patient's health care will be available at a click of a mouse.

But NPR's Joanne Silberner reports that's going to take a little convincing.

JOANNE SILBERNER: Earlier this spring, Medicare administrator Kerry Weems went out on the road.

Mr. KERRY WEEMS (Medicare Administrator): So what we're here to talk about are electronic health records.

SILBERNER: He was talking to several dozen doctors, hospital officials and insurance company representatives in Baltimore. His goal: convince them to be part of a pilot project for computerization.

Mr. WEEMS:: You know, we know electronic health records can save money, can improve health outcomes through better care and avoid duplicative tests, avoid some invasive tests, and perhaps even reduce administrative costs.

SILBERNER: Internet companies like Google and Microsoft are marketing individual health records where patients fill in their own information. But most health officials believe the big payoff is where doctors and hospitals directly computerize their charts. The benefit for patients is that doctors can see the full health record. Insurers can better monitor the care the doctors give, but doctors themselves don't benefit financially. So at that Baltimore meeting, Medicare administrator Kerry Weems got some pushback from Ronald Strocka(ph). He is an old-style family doctor who's been in the same office in suburban Crofton, Maryland for 30 years.

Dr. RONALD STROCKA (Physician): Being a primary care physician and solo practitioner and having been with larger groups, it's my category that's going to be impacted the most, for one physician to have to - to have to share the costs alone.

SILBERNER: Which is why the Department of Health and Human Services is pushing the pilot project. In 12 areas around the U.S., including Maryland, doctors will be able to apply to get up to $50,000 over the next five years for computerizing. Group practices can get $290,000. But that may not be enough. Sally Sawler(ph) is the administrator for a practice at 17 doctors, and by her estimate, $290,000 just won't do it. She's calculated it would cost several times that amount.

Ms. SALLY SAWLER (Administrator): And there's more than just a hardware/software cost. There's huge costs in training. I might have to hire an I.T. person to handle all the additional infrastructure for these medical records.

SILBERNER: And she's still got 40 years of paper medical records to store somewhere. Physician Ronald Strocka voiced several other concerns. Would his patients' records remain private? Would insurers use the information to tell him how to practice medicine? And one more...

Dr. STROCKA: A standard system for what everyone should use has not been established. It is very possible and has already happened that physicians expended large amounts of money on a program that turned out wasn't interactive with the people that they needed to interact with because they were with a different program.

SILBERNER: That's something the Department of Health and Human Services has been working on for years. And Secretary Michael Leavitt says that while standardization efforts are moving slower than he'd like, they are moving along. Dr. Strocka thought about it after leaving the meeting, and now he says he's leaning towards applying to be in the pilot project.

Dr. STROCKA: I think it's coming whether I like it or not. And somehow or the other I'm going to have to afford it, regardless of whether I want to or not.

SILBERNER: Medicare officials will collect data during the pilot project, seeing whether or why physicians drop out and whether Medicare needs to do anything else to get more doctors to sign on. Administrator Kerry Weems expects some problems along the way. If establishing a national system of medical records were going to be easy, he says, it would have been done already.

Joanne Silberner, NPR News.

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