Info technology more available to small practices

Greater affordability and accessibility is cited, although price is a sticking point for many doctors.

By Tyler Chin, amednews staff. Sept. 23/30, 2002.

Internet-based technologies and new business practices by software companies are helping lower barriers that once made it impractical for solo and small physician practices to use technology outside the billing arena, according to a new report.

Interviews with doctors at more two dozen solo and small practices found that those doctors are using more technology to address nonbilling-related problems because clinical information technology is more accessible, useful and affordable than before, said Jane Metzger, co-author of the report "Achieving Tangible IT Benefits in Small Physician Practices."

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Several factors drive smaller practices to use technology, said Metzger, research director of First Consulting Group, a Long Beach, Calif.-based health care technology consulting firm that prepared the report for the California Health Care Foundation:

Web-based technologies and widespread access to the Internet allow software companies to design software that can be accessed and maintained remotely at a lower cost than traditional systems that carry huge upfront costs.
Software companies now are designing and selling modular products, that allow doctors to buy only what they need instead of expensive "monolithic systems that do everything."
Smaller, portable computing devices make it easier for doctors to use technology at the point of care.

Although those factors have made technology more feasible for small practices, Metzger said physician implementation of technology in that setting still is in the early stages. Cost remains a significant barrier.

"Physician practices, especially smaller ones, haven't had much margin, and today they probably have even less," Metzger said. "I think it's why we see in the smaller practices physicians tackling something they have agreed is a priority for them."

Most of the doctors who First Consulting interviewed did not do a formal return-on-investment analysis. But they thought that their investment had paid off, even though they couldn't quantify the benefits.

In the report, Andrew Murphy, MD, a West Chester, Pa., allergist and immunologist, couldn't say whether a handheld electronic reference guide had saved money or increased his productivity. But he thinks it helps him deliver better care to patients because he can more easily access drug interaction information. Quick up-to-date access to dosing, cost and other drug information also help streamline patient visits, he said.

Howard Landa, MD, a urologist in Loma Linda, Calif., said that in six months, he cut monthly transcription costs from about $1,200 to about $50 with a Web-based notes program.

One reason why those doctors successfully implemented technology in their office is that they got it to solve a particular problem instead of buying technology first and figuring out later what to do with it, Metzger said.