ONLINE MEDICAL RECORDS: Software Cost, Reliability Present Hurdles for Doctors

      Most doctors' offices utilize computer databases for billing purposes, but "that's as far as it goes" -- most patient information still is "kept on yellowing slips of paper," as many doctors are reluctant to switch to a computerized system, NPR's Larry Abramson reports on "All Things Considered." As few as 5% of doctors in small practices use computers to keep track of patient information, Abramson reports. For most doctors, the cost of implementing such a system -- which can be upwards of $200,000 -- is their primary concern. Whether the system will prove its worth in the end and whether the software will remain current after a few years are also concerns. Dr. Bruce Bagley, president of the American Academy of Family Physicians, speculated that doctors are too accustomed to running their practice on a day-to-day basis and often fail to think about the future. Seth Powsner, an associate professor at the Yale Center for Medical Informatics, added that doctors must weigh the benefits of using computerized records -- reducing errors and the length of hospital stays -- against the time and effort it takes to input patient information into such a system. Further, Powsner said, the software has "a long way to go," as it can be difficult to use and "crashes" easily. Some doctors also might find a computer format too restrictive, Powsner said. He added, "When a person meets a computer, one of them has to give and very often, that's not the computer. So, if you tell physicians something that doesn't fit the format, what's going to happen? ... [T]he data's not going to go in."

Hold the Paper
      But for Washington, D.C., doctor Peter Bash, paper charts "make it harder to practice good medicine," and that's why his office has enlisted the services of MedicaLogic. Each of Bash's examining rooms houses a computer, situated so that both patient and doctor can see what's on the screen. That way, Bash can double check with the patient about current medications and allergies, while drawing the patient into the process. While Powsner said that the move to computerized records is "inevitable," he added that "both patients and doctors shouldn't expect too much" too soon (Abramson, 7/17). To hear an audio file of Abramson's report, visit http://www.npr.org/ramfiles/atc/20000717.atc.04.rmm