Helping Small Practices Adopt Health IT

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The benefits and challenges of implementing health information technology, particularly for solo and small group physician practices, are highlighted in two new Commonwealth Fund-supported studies published today in Health Affairs.

In The Value of Electronic Health Records in Solo or Small Group Practices, Robert H. Miller, Ph.D., and colleagues at the University of California, San Francisco, conducted 14 case studies of solo or small primary care practices that had used electronic health records (EHR) for one to three years. While start-up costs averaged $44,000 per physician or nurse practitioner, small physician practices recouped the cost of investing in EHRs in two-and-a-half years, the authors found. Efficiency savings and gains from greater physician productivity, meanwhile, averaged $15,800 per physician or nurse practitioner per year.

However, physicians faced barriers to implementing the technology, including difficulty with obtaining training and changing practice processes to adapt to EHR capabilities.

In the second study, Functional Gaps in Attaining a National Health Information Network, Rainu Kaushal, M.D., M.P.H., of Brigham and Women's Hospital in Boston, and colleagues convened an expert panel to develop a model national health information network that would be attainable in five years, taking into account financial, personnel, and technical constraints. Given current health information technology adoption trends, smaller providers, such as home health agencies and skilled nursing facilities, will likely lag behind larger providers due to limitations in financial resources and personnel, the report found.

Still, the study estimates implementation of these technologies will likely triple or quadruple in the next five years, with EHR functionality increasing from 9 percent to 25 percent in small practices, and from 15 percent to 38 percent in larger practices.