Nationwide, physicians have not embraced electronic medical records as quickly as anticipated at the beginning of the decade.”It hasn’t happened,” said Brian Schatz, chief operating officer at Medical Associates Clinic.

The clinic began implementation of an electronic medical record system in April 2003.

“We are basically 90 percent deployed,” Schatz said.

The clinic’s extensive use of electronic records places it within a minority.

A recent New England Journal of Medicine report indicates about 4 percent of physicians have “robust” electronic medical record systems capable of order entries and clinical decision support, with 13 percent of physicians using more basic systems for handling laboratory data, clinical notes and electronic prescribing.

“We believe this is the way medical information will be handled in the future,” Schatz said. “We believe we are practicing better, safer medicine.”

In a national survey, two-thirds of the physicians who haven’t adopted such technology cite cost, difficulty finding the right system, and fear of quick obsolescence as the factors in their decisions, the New England Journal of Medicine reported.

More than 2,750 physicians were sampled by the Institute for Health Policy at Massachusetts General Hospital through March 2008. The survey found stronger adoption of electronic medical records in larger practices, in facilities and in the western United States and among younger physicians.

“I think physicians are conservative as a whole,” said Mike Stoll, president of the Tri-State Independent Physicians Association. “The longer they are in practice, the more ingrained they become.”

Practices of 50 or more physicians were three times as likely as doctors in practices of three or fewer physicians to have basic electronic medical records, according to the report.

“Larger (physician) groups have definitely been at the forefront in deploying the technology,” Schatz said. “One of the issues is the investment piece. This is a capital-intensive thing. Smaller groups don’t have access to that investment.”

The clinic spent nearly $4 million on the electronic medical records project, including hardware, software and personnel directly related to the change.

“It is not just capital intensive, there is a human investment,” Schatz said. “We have had to relearn how we do business - it takes energy, effort and time. Some people adapt very quickly and some people adapt more slowly.”

Technological expertise can sometimes come easier for larger physicians’groups.

“Larger groups tend to have IT (information technology) capabilities in-house,” Schatz said. “Smaller groups might not even have an IT person.”

Stoll said the IPA plans to purchase an electronic medical records system for the association.

“When you can spread it out, it becomes far more affordable,” he said. “For our group, we have targeted Jan. 1, 2010.

Originally published by ERIK HOGSTROM TH staff writer/ehogstrom@wcinetcom.

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