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2007 - The Year in Review

The health care industry continues to lag behind others in its adoption of technology. Indeed, it devotes only 2 percent of its gross revenues to technology, compared to the 10 percent regularly allocated to technology products and services by financial services firms, according to a study sponsored by Kaiser Permanent Institute for Health Policy.

So, looking back upon 2007, the big news in physicians' practices is the increasing acceptance and adoption of technologies that have been around for a while, but which had previously failed to gain traction.

"Physicians are under tremendous pressure to deliver higher quality care at less cost, and they're beginning to understand that technology is the way to achieve this," says Robert James Cimasi, President at Health Capital Consultants LLC, in St. Louis.

Electronic medical records (EMR) software provides a case in point. Broadly defined as information systems that manage medical information – both clinical and administrative – EMR has been around for years. Yet it has been slow to take off. Today most healthcare transactions are still performed and recorded using paper. As of 2005, only 12 percent of healthcare providers who participated in the National Ambulatory Medical Care Survey had installed EMR systems. However, there was good news as well: when accounting for the healthcare providers in process of implementing EMR, as well as those who were in the planning stages of moving to the technology, EMR adoption is expected to reach 60 percent by 2008.

Fitting In
"Practices are finally beginning to use technology to try and mimic their regular workflow," says Babak Pourmassina, president of Physicians Info Systems, a healthcare IT consulting firm in Seattle. "It's not revolutionary technology, but a lot of the younger physicians just entering the field are pushing the move to electronic paperless systems. As they join practices – and as older physicians retire – adoption of EMR systems is escalating. Additionally, the move toward pay-for-performance (P4P), which ties physician compensation to quantitative measures of treatment efficiency and effectiveness, is driving increased use of information systems. "P4P is making physicians thirsty for information," says Cimasi. "As the trend toward P4P continues in 2008 and beyond, the need for EMR will grow."

And there's a snowball effect. Once EMR systems are in place, physicians begin looking to implement other technologies that can make them more efficient, save money, or provide higher quality of care.

Technologies that make information "portable" fall into this category. Using personal digital assistants [PDAs], the new smart phones, and tablet PCs, physicians are beginning to take data to go. "These are very powerful tools, as they dramatically streamline the ability of physicians – especially those with relationships to hospitals or clinics – to work efficiently and effectively at the point of care, no matter where that happens to be," says Sheri Stolzenberg, CEO of Stolzenberg Consulting, a medical systems consulting firm, in Pittsburgh, Pennsylvania. Agrees Cimasi, "Patients can see five or 10 different doctors. Making all their information available to their caregivers wherever they are located – that's huge."

Continuing Trends
Another major trend of 2007, one that will keep growing in 2008, is the use of patient portals, says Sue Hertlein, a senior consultant in the IT division of the Coker Group, a health care consulting firm based in Atlanta. These are Web-based applications that allow patients to log onto a secure Website and request physician appointments, prescription refills, educational materials, and even lab results. They can also ask questions by sending emails to their doctors or advice nurses.

Additionally, there are increasingly links between physicians' offices and insurance companies over the Web. Previously, doctors needed to call insurance companies to verify if patients were covered for particular treatments. Because many physicians practices typically don't do that until after a patient has been seen. Having the electronic links available to "prequalify" patients can result in dramatic time and cost savings.

Finally, actual leading-edge technologies such as speech recognition and handwriting recognition saw some progress in 2007 but the training and expense of implementing them – and the low success rate due to poor implementations – has kept most physicians from adopting them. Experts put mainstream acceptance of those technologies as much as five years out.

Still, there's an urgent need for these technological advances to continue. "Although it’s a bit disappointing to witness the slow rate of adoption of these innovations, we are starting to see progress, and we expect them to continue along the same trajectory in 2008," says Hertlein.

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