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EHR systems in development could bring relief for solo physicians

A leading expert tells doctors in solo and small practices not to give up, because EHR systems are coming that will be tailored to their needs -- and ready to meet meaningful use rules.

WASHINGTON, D.C. -- New electronic health record (EHR) systems under development will bring relief to solo physicians using paper-based medical records who think they will be forced to implement an imperfect system, close up shop and join a larger organization -- or simply retire.

That's according to Dr. David Kibbe, founding director of the Center for Health Information Technology for the American Academy of Family Physicians (AAFP), which represents 95,000 physicians, mostly ones in solo and small practices.

In his presentation at the first AMA-IEEE Medical Technology Conference on Individualized Healthcare, Kibbe said solo doctors are demanding basic, inexpensive EHR systems that don't carry a high cost of switching to another system if a particular one doesn't work for them. A low switching cost is important because doctors are afraid of sinking so much time, money and bandwidth into an EHR system that they will forced to stick with it, even if the marriage is an unhappy one.

Open source vendors, such as Medsphere Systems Corp., currently offer free EHR software that is gaining traction among solo physicians and small practices, Kibbe said -- and for good reason, because it satisfies many of their needs.

Kibbe, who is working with a vendor to develop an EHR system for solo physicians, said he knows other vendors are working on similar EHR options for smaller clinical installations. These future systems will likely be cloud-based, will integrate with smartphones, and will be extensible to accommodate a practice's expanding needs, he said.

EHR vendors will link physicians, meaningful use money

In addition to his work with the AAFP, Kibbe cowrote the Continuity of Care Record standard for the American Society for Testing and Materials. Under the federal government's proposed meaningful use criteria, patients should receive a Continuity of Care Record that describes what occurred during a doctor's appointment and provides lab test results.

Ultimately, EHR vendors may be the missing link between physicians and meaningful use certification, Kibbe said. The federal government's incentive plan falls short, some doctors describing it as "a paltry amount, given today's market."

My prediction [is], many of the small medical practices will sit out the first year or two of the meaningful use program.

Dr. David Kibbe, founding director, AAFP Center for Health Information Technology

"It's important to understand that meaningful use, on the vendor side, is critically important," Kibbe said. "All the vendors now are building to the meaningful use criteria; the EHR [system] standards that are associated with the interim final rule; and now, the certification process, which is the third leg of the stool. … My prediction [is], many of the small medical practices will sit out the first year or two of the meaningful use program. However, none of the vendors can afford to sit out," he said.

After his presentation, Kibbe told that solo doctors still using paper -- and contemplating retiring rather than implementing an EHR system -- should hang in there. Help is on the way; if you're feeling pushed by EHR vendors, push back.

"Just stay in practice, do good work and don't worry about it," Kibbe said. "I get this question all the time from those physicians, and they're very pained about having to make this decision. … Generally speaking, they've only looked at the very high-end, complicated systems … and they've been told by the vendors they have to make a decision now. Wait a minute. Don't be panicked. This is going to take place over five or six years. Products and services are coming on the market that are cheaper, easier and less difficult to implement. You don't have to feel rushed into this," he added.

Let us know what you think about the story; email Don Fluckinger, Features Writer.

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