Have physician offices become more wired?

An online survey reports that computer usage levels for nonadministrative purposes are up, but some say the numbers are inflated.

By Tyler Chin, amednews staff. Dec. 2, 2002.

Wired physician offices are increasingly using and looking to buy technology for clinical purposes, according to a recent online survey by the Healthcare Information and Management Systems Society.

About 99% of the 453 physicians and practice administrators who responded reported that their practices used computers. (More than 5,000 doctors and practice managers were invited to participate in the survey.)

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Although respondents primarily used computers and software for administrative purposes, the survey also found that they "were more connected than perhaps thought" in terms of using technology for clinical purposes, said Carla Smith, executive vice president of membership and professional services of HIMSS, a Chicago-based health care technology industry group that conducted the Web-based survey.

For example, 28% said they used electronic medical records software, and 72% used handheld devices, primarily personal digital assistants. Physicians said they used their handheld devices to look up pharmaceutical information before prescribing drugs for patients (69%), to schedule patients (41%) and to capture charges (28%). Another 19% used the devices for electronic prescribing and 18% for clinical note taking.

About 91% of the respondents said they planned to buy software, networking equipment or hardware in the coming year. Fifty-seven percent planned to spend $50,000 or less; 25%, between $50,000 and $500,000; 9%, more than $500,000; and 9% did not know how much they would spend.

Thirty-eight percent planned to buy an electronic medical record system within the next 12 months; 28%, a handheld device; 27%, networking equipment; 20%, registration/scheduling software; 17%, billing software; and 16%, clinical software.

Most physicians use computers in their practices, but primarily for administrative tasks.

Approximately 98% of the respondents have access to the Internet at the office. Of those, 21%reported that they discuss clinical issues with patients via electronic mail, a statistic that some doctors believe to be extremely high.

"It's just not true," said Cliff Molin, MD, an internist in Cleveland. "It's just not happening at that level. I think that even at 5% it's still probably high."

Dr. Molin, a self-described technophile, has observed an increasing number of doctors using technology over the last three years, but the level of usage, though rising, isn't as widespread as the HIMSS/AstraZeneca survey suggests, he said.

Noting that a Web-based survey would naturally draw responses from physicians who are savvy about technology, Dr. Molin said he doubted the finding that 72% of physician offices use handheld devices such as personal digital assistants and tablets. "I think that is very high unless I'm in a very backward area," he said.

Dr. Molin writes prescriptions, looks up drug information and captures hospital charges via a wireless PDA but hasn't seen many colleagues using handheld devices in their offices or when he goes on rounds.

He is interested in using an electronic medical record but isn't planning to buy one soon. "It's still quicker and more efficient for me to just use a paper-based system," he said.

"EMRs are the way to go," but doctors won't embrace them until the systems are as efficient to use as paper, he said. "I think in 10 years time you will see 80% of physicians using EMRs. That's my prediction. Physicians have the attitude of, 'Stand back and wait and see.' Let everybody else experiment, and when something is obviously good they will jump on it."

ADDITIONAL INFORMATION:

Tech-savviness

The 2002 HIMSS/AstraZeneca Clinician Wireless Survey looked at how wired physician practices used technology. It found that:

98% had Internet access.
98% had computers located in at least one administrative area.
72% used handheld devices.
70% of physicians used handhelds as a reference on pharmaceuticals before prescribing drugs for patients.
68% had computers located in at least one clinical area.
41% of doctors used handhelds for patient scheduling.
28% used electronic medical records.
21% exchanged e-mail with patients.