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The good news is that the majority of America’s physicians agree that technology and the Internet are likely to make tremendous transformations in how medical practices operate in just a few years. Indeed, experts say technology is available to allow physicians to streamline operations and improve efficiency. The bad news is that many physician practices are slow to adopt technology, and those that don’t move soon may be left behind.
"With the exception of a few large hospital groups, we have not seen a lot of technology assessment taking place. I encourage physician practices to complete their assessment quickly to see what they need to do. The real message is to embrace technology for the office just as you would for the clinical side," says Lee Akay, managing partner for PricewaterhouseCoopers MCS Healthcare Practice in Pasadena, CA.
Akay’s firm co-sponsored a survey on physicians and the Internet conducted by Harris Interactive for the Health Technology Center, a San Francisco-based nonprofit organization that promotes the use of new health care technologies. The survey showed that the potential for using the Internet is growing more rapidly than most industry observers thought possible.
The study surveyed physician leaders and office-based practicing physicians and found widespread agreement that computers have already had a positive impact on the practice of medicine and quality of care. More than one-third of those surveyed said Internet-enabled clinical and business services offer a clear advantage, and 96% said these technologies will improve quality of care by 2003. (See table.)
|Six essential’ Internet-enabled services|
|Physicians responding to the Health Technology Center survey on technology identified the following six services as "essential" for future use and found them valuable because they reduce administrative costs, speed payments, and improve quality of care (figures in parentheses indicate the percentage of physicians now using the services):|
|•||diagnostic reporting (34%)|
|•||claims processing services (35%)|
|•||pharmaceutical information (34%)|
|•||purchase of medical office products (29%)|
|•||e-mail communication with patients (29%)|
|•||electronic medical records (19% are testing or have implemented EMR)|
"The message we heard over and over is that there is a payback for technology, both financially, in terms of time, and in improving quality and tying the patient to the physician," says Genny Jacks, senior advisor with the Health Technology Center. Technology gives physicians the information and control they need to develop strong relationships with their patients, Jacks adds. For instance, with Internet technology, a primary care physician doesn’t just turn patient care over to a specialist; he or she can coordinate the data flowing to them and participate in the care.
If patients have questions, they can e-mail their doctors rather than staying on hold or waiting for the telephone. If patients have a chronic disease, the Internet allows the doctor to help them manage it without coming into the office. "In the early days, when people talked about managed care, they meant coordinated care, being able to anticipate, prevent, and manage problems. This communication technology enables physicians to do just that," Jacks says.
The survey showed that physicians already are getting diagnostic reports and laboratory values and communicating with ancillary providers and hospitals over the Internet, Jacks says.
Technology can help physician practices improve performance and customer service as well as boosting their own satisfaction with how their business is run, points out Michael J. Alper, president of Meridian Health Care Management, a managed care consulting firm in Woodland Hills, CA. "The impact of not taking advantage of today’s technology means that it will cost physicians more to run their business and that their patients will become dissatisfied because it takes longer for things to happen," he says.
One typical response from physicians is that they don’t want their staff to have access to the Internet because it may take time away from doing their work. "That is just a temporary response for not changing current operations," Alper says.
In today’s health care environment, doctors have got to see more patients every day to bring in more dollars, even in a capitated environment, points out Henry Golembesky, MD, FAAP, a pediatrician and principal with CSC Consulting in San Francisco. The Internet offers practices a way to gain efficiency without significant cost, he adds. "It’s an exciting time. We can no longer say that the technology isn’t there. It’s available. It’s a matter of how we get it in place and make it work so work flow is enhanced rather than slowed down," Golembesky says.
Cost is no longer an excuse for not shifting to technology, he adds. Computers are inexpensive, and application service providers are a quick way to link your practice with the outside world without a big capital investment, he adds. "It’s not often that a specialist has all the information he or she needs about a patient’s past medical history, laboratory and X-ray information. They are making decisions based on fragmented information or duplicating things they don’t have to do. It’s not a matter of these being bad doctors or bad hospitals. It happens even in the best of organizations," he says.
The Internet and other technology has the potential to give doctors the information they need to decide what course of treatment a patient needs, Golembesky says.
"Many hospitals are providing linkages to doctors’ offices using Internet technology. It allows a doctor to look at progress notes, laboratory and X-ray studies and follow the patient from the office to decide what to do between visits," Golembesky says.