Doctors working alone or in small practices face bigger financial challenges switching from paper to electronic medical records than larger health organizations, researchers report.
A study of 14 solo and small group practices in 12 states found that small physician practices, on average, take 2.5 years to recoup the cost of investing in electronic health records. The average start-up costs are $44,000 per physician or nurse practitioner, along with annual maintenance costs that average $8,400 per physician per year, according to researchers at the University of California, San Francisco.
On the other hand, the study found that improved billing using health information technology boosted practice revenues by $17,000 per physician per year, while efficiency savings and gains averaged $15,800 per physician per year.
Smaller practices may also have difficulty finding adequate training for staff adapting to these new technologies, suggesting the need for improved technical and practice redesign support services, the study authors said.
"With almost three-quarters of physicians in solo or small-group practice settings, it is critical to recognize not only the financial barriers, but the greater need for technical assistance in implementing electronic health records, compared with physicians in larger health care settings with existing support systems," Dr. Anne-Marie Audet, vice president of the Commonwealth Fund, said in a prepared statement.
The nonprofit Commonwealth Fund provided financial support for the research, published in the September/October issue of Health Affairs.
"Health care leaders and policymakers must also address the significant difficulties physicians in solo or smaller practice settings face in using electronic health records to improve quality. We cannot forget that the primary purpose of these new technologies is to improve quality of care for patients," Audet said.
A second study in the same issue said that, given current trends, smaller healthcare settings (small physician practices, home health agencies and skilled nursing facilities) will lag behind hospitals and larger institutions in projected health information technology capability over the next five years.
More information
The American Health Information Management Association has more about personal health records.
