HEALTH POLICY FACT SHEET Debra Street Jeralynn S. Cossman
March 2008
Mississippi Physician Reports of Technology Use in Practices: Computers and Electronic Medical Records Computer use for professional tasks among physicians has become ubiquitous and medical community stakeholders throughout the United States are transitioning to new forms of medical record-keeping technology to match the needs of its 21st century health care system. From President Bush’s 2004 agenda for electronic medical records for every US patient by 2014, to the proliferation of software vendors, to task forces on adoption and integration of computerized professional practices, and to the exhortations of professional organizations, physicians and hospitals are experiencing steady pressure to increase technology use in their medical practices, including electronic medical records for their patients. Mississippi physicians are likely no different from their counterparts elsewhere in the country in their routine use of computers in medical practices. As Figure 1
The Mississippi State Medical Association, the Mississippi Academy of Family Physicians, the American Academy of Family Physicians, and the Social Science Research Center at Mississippi State University sponsored a recent physician workforce study (2007 MSMD) of doctors licensed (during 2006-2007) to practice in Mississippi. More than 1400 doctors responded to the 2007 MSMD web survey; data reported in this brief are from the 848 licensed Mississippi doctors in active patient care practice, in state, in 2007. This is the second in a series of Fact Sheets and Policy Briefs from the 2007 MSMD Study.
depicts, most physicians who responded to the 2007 MSMD survey reported they routinely use computers to send prescriptions to pharmacies, to update their professional skills through continuing medical education (CME) courses, and to receive lab results, Xrays, and hospital records for their patients. About 2 in five Mississippi doctors reported updating electronic medical records and about 1 in five communicate with patients via the computer. Doctors report substantially lower levels of computer use for activities like looking up treatment modalities (fewer than 15%) or monitoring/treating patients through practicing telemedicine (around 8%).
Figure 1. Mississippi Physicians Practice-related Computer Use. 80%
70%
60%
50%
40%
30%
20%
10%
0% Send prescriptions to pharmacies
Take courses for CME credits
Receive lab results, x-rays, hospital records
Update electronic medical records
Communicate with patients
Look up information about treatment alternatives
The Mississippi Health Policy Research Center is a division of the Social Science Research Center at Mississippi State University.
Provide care via telemedicine
Mississippi Physician Reports of Technology Use in Practices: Computers and Electronic Medical Records
One specialized use of computer technology in medicine is electronic medical records. Electronic medical (or health) records (EMR/EHR) are held out as technology tools with the potential to improve the quality and efficiency of health care delivery. However, the pace of widespread adoption has been impeded by several factors. The proliferation of software packages and the lack of a single national standard create integration challenges across provider sites. Many consumer advocates express concerns about pervasive risks to confidentiality that electronic data-sharing may pose for the privacy rights of patients. Finally, the costs of purchasing software systems and then learning and implementing electronic medical records, particularly in solo and small physician practices are substantial. It is estimated to cost from $16,000 to $36,000 to get an EMR system up and running, according to a 2005 study by the Congressional Research Service. A recent review of research studies of the adoption and use of electronic medical records generated a tentative national estimate that about 24% of physicians use electronic records in ambulatory settings.1 This national estimate is slightly lower than the upper range of estimates from the American Academy of Family Physicians (AAFP) at 20,000 to 24,000 members2 (2126% of its 94,000 members nationwide) who have already adopted electronic medical records. The differences in the estimates may be simply a matter of passage of time—the AAFP estimate is more recent than the overview of research conducted earlier in the national study. Both national and AAFP estimates are substantially lower than those reported by the physicians who responded to the 2007 MSMD. More than 40% of Mississippi doctors in our study reported that they were already using electronic medical records in their primary practices, and another 25% are well on the way to adopting EMRs. Interpret these findings with caution, since respondents to a web-based survey like 2007 MSMD, may be physicians who are most comfortable with technology, and more likely than others both to use EMRs and to have participated in this study. The 24% of physicians who reported that they would use EMRs if resources were available reflect the cost barriers—both in terms of time and money—to adopting new technology.
Computerized technology and EMRs are becoming integral parts of physician practices throughout Mississippi, as is the case in doctors’ offices and clinics throughout the rest of the country. In states with large rural populations, like Mississippi, computerized telemedicine may be another way to expand access to health care. Web-based interfaces for physicians can provide critical information and services in emergency situations, as was the case in the aftermath of Hurricane Katrina.3 Physician use of EMRs is likely to become more widespread as several government agencies, such as the Veteran’s Administration and the Department of Defense, have programs to implement them throughout their services, and the Centers for Medicare and Medicaid Services is offering incentive payments to small practices adopting EMRs to improve clinical care in a five-year pilot program. Most Mississippi physicians in our study are clearly on the same path as their colleagues throughout the country in their widespread use of modern information technology in their practices.
REFERENCES 1
How Common Are Electronic Medical Records in the United States? A Summary of the Evidence by Ashish K. Jha, Timothy G. Ferris, Karen Donelan, Catherine DesRoches, Alexandra Shields, Sara Rosenbaum and David Blumenthal . 2006. Health Affairs, 25(6): w496w507, doi: 10.1377/hlthaff.25.w496. 2
Medicare Pilot Project to Pay More to Doctors Who Use EMRs by Dave Hansen, Nov. 26, 2007. http://www.amaassn.org/amednews/2007/11/26/gvsa1126.htm
3
Hurricane Katrina’s Effects on Mississippi’s Health Care: Physician Reports from the 2007 MSMD Survey by Jeralynn Cossman and Debra Street. 2007. Mississippi Health Policy Research Center Fact Sheet.
AUTHORS Debra Street is an Associate Professor in the Department of Sociology and Faculty Fellow of the Regional Institute at the University at Buffalo, SUNY. She was elected to the National Academy of Social Insurance in 2007. She can be reached via email at:
[email protected] Jeralynn S. Cossman is an Associate Professor of Sociology at Mississippi State University. She is a Research Fellow for the Social Science Research Center and the Mississippi Health Policy Research Center. She is also the Director of the North East Mississippi Area Health Education Center. She can be reached via email at:
[email protected]
Mississippi Health Policy Research Center Social Science Research Center, Mississippi State University
PHONE: 662.325.7127
FAX: 662.325.7966
WEBSITE ADDRESS: http://www.healthpolicy.msstate.edu
Mississippi State does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or veteran status. This research was funded by Mississippi State University, the Mississippi Physician Care Network, the Mississippi Academy of Family Physicians and the American Academy of Family Physicians. This research reflects the work of the authors and does not necessarily reflect the opinions or positions of the funding agencies.
