Health care, in regard to its adoption of technology, is sprinting forward in a last-lap attempt to catch up with almost every other industry. Unfortunately, this surge is putting a great deal of pressure on physicians, who seem to be facing the fullest force of the attack. Today, physicians are facing pressure from payers and healthcare systems alike to implement technology in different aspects of their practice. This pressure could be as simple as payers processing electronic claims immediately, but waiting 90 days for paper claims. The pressure could also be quite a bit more.
Partners Health Care, a large Boston system, has created a policy that forces physicians to implement or sign a contract for an EMR system by Jan 1, 2008. This policy is specifically aimed at primary care physicians within the contracting network. A similar policy will be enacted on Jan 1, 2009, for specialists. If the physicians do not agree, they will be expelled from the network and will lose privileges at Partners hospitals and the ability to contract with managed care plans through the system.

Pressure is coming from the government as well, making it even harder for practices to put off spending the cash for new technology. The Medicare Electronic Medication and Safety Protection Act, introduced as SB 2408 and HR 4296, aim to “encourage” the adoption of e-prescribing by physicians for Medicare patients. The bill will reward physicians who submit claims including an electronically produced prescription with a 1% bonus payment. However, after Jan 1, 2011, physicians will be financially penalized for claims with hand-written prescriptions. Grants will be made available to physicians to cover startup costs under this piece of legislation, but will total only $2000 annually for the first two years, then decline after that.

The Commonwealth Fund, a think tank out of Boston, issued a report in November urging the next president to mandate the adoption of electronic health records. The report titled “Bending the Curve: Options for Achieving Savings and Improving Value in US Health Spending,” focuses on patient care quality and efficiency. The suggested mandate includes pieces requiring physicians to adopt EHRs and participate in Regional Health Information Organizations (RHIOs) and Health Information Exchanges (HIEs). While no presidential candidate has advocated this mandatory action, many support the promotion of healthcare information technology. The above example detailing the Partners Health Care initiative only proves that such a mandate is plausible. The questions remains, could this be successful on a large scale?

One potentially beneficial aspect for physicians is the funding recommendation. The same theme is apparent across the entire healthcare IT spectrum: Insurance providers reap a far greater reward from technology than do providers. This is true with individual EMRs and EHRs, as well as with regional efforts such as RHIOs and HIEs. The Commonwealth Fund study recognizes this and promotes a 1% tax on premiums to be paid by the insurance companies. Of course, there is a very good chance that this cost would be directly passed on to the patients.

Unfortunately, the pressure does not stop at external forces; physicians are seeing a greater desire for practice technology from their own patients. A recent Harris Interactive poll shows that 74% of patients want the ability to use email or a website to ask their physicians questions and to schedule appointments. They also want to receive test results and care reminders electronically. This number is alarming when compared to Harris Interactive findings that more than 80% of primary care physicians surveyed in California (outside of the Kaiser Permanente system) rarely or never communicate with patients online. Simple economics explains that the market will adjust when supply and demand do not meet, which means more physicians will be adapting to current trends.
Technology today is progressing very quickly and the healthcare industry is struggling to keep up. However, innovations in other industries are beginning to trickle over into the healthcare arena—for example, the idea of the personalized video blog. Some physicians are posting videos to patients on the practice website giving directions or helpful information. These physicians are also sending personalized video emails to patients explaining lab results or reminding the patients to schedule follow-up appointments. This is one way that technology is allowing the physician to easily add a personal touch to patient care.

The lay community is also embracing technology concerning health care that goes beyond self-diagnosing on websites or search engines. Consumers have created networking sites for patients with support groups for countless conditions. Rating sites have also become a popular medium for patients to comment on their experiences with their physicians. There is also an overwhelming amount of blogs, video sites, and wikis (a website open to anyone to post, edit, and delete information) designed to quickly and efficiently deliver information to consumers.

The information age is hitting the healthcare community with full force. Physicians are seeing pressure from patients, payers, the government, and external markets. Technology is becoming so ingrained in our society that physicians are finding it difficult to avoid embracing it. However, although the future will force technology on the physician, it might bring with it lower costs and outside funding. The question remains, how long can you hold off?