Roadmap for health IT

Cost and privacy issues must be addressed if lawmakers want to encourage physicians to invest in technology -- and fulfill its promise.

Editorial. May 7, 2007.

If Congress wants to encourage greater electronic medical record adoption, it needs to address two major concerns.

One is providing the right incentives so that physicians in any size practice can make a business case for information technology. The other is making privacy and security a top priority to allay patients' concerns about who is seeing their information, and how it is being used. That way, health IT can fulfill the promise to serve both doctor and patient.

Physicians' use of EMRs, especially in smaller practices, is low, in part because of the high expense and small return in investment and system upkeep. As the AMA pointed out in a March 28 statement to the House Committee on Small Business Subcommittee on Regulations, Healthcare and Trade, the Congressional Research Service estimates that the per-physician startup cost for an EMR can range from $16,000 to $36,000. Then, a practice has to spend around $8,500 per year, per doctor, and on ongoing costs, such as software licensing and software and hardware upgrades, according to a study published in the September-October 2005 edition of Health Affairs.

The hearing was held as a fact-finding affair. No IT bill is expected to go through Congress in 2007 after competing House and Senate measures failed to find traction in the other's chamber last year.

Lawmakers -- and this also holds true for the AMA and many other physician organizations -- see great promise in the potential of health IT to raise the overall quality and safety of care. In addition, there appears to be general agreement that incentives are necessary to encourage widespread adoption, though no bill has completely addressed physicians' concerns.