Policy Reforms Needed to Grow E-Health

Published June 1, 2008

The U.S. health care payment system and lingering privacy issues are deterring doctors and patients alike from embracing efficient and accessible e-health technology and solutions, experts say.

Without health care reforms to accommodate the new technology, e-health will struggle to become widespread, they warn.

“[E-health adoption] is going to be gradual, and there are going to be small pockets that are adopting e-health and using it really widely,” said Lygeia Ricciardi, principal and founder of Clear Voice Consulting, a practice focusing on e-health and consumers. “But in order to get everyone on board, it’s going to take at least 10 years, maybe a generation.”

E-health technology allows patients and doctors to create and update medical records using computer programs and the Internet. The files can travel easily between different health care offices, giving doctors more complete information about their patients, which can result in more accurate diagnosis and better treatment.

The technology eliminates the hassle and inaccuracy of a system where patients–who sometimes are in significant pain–must try to remember their health history and write it on a clipboard paper before receiving treatment.

Prohibitive Startup Costs

The initial expense of e-health keeps many doctors from making the switch, said Christine Bechtel, vice president of eHealth Initiative, a Washington, DC-based nonprofit that advocates improvement in the quality, safety, and efficiency of health care through information and information technology.

The programs can cost a practice $10,000-$50,000 per physician, Bechtel explained, and training offices to adopt the electronic records as they process patients can cost even more.

Another problem is that most physicians get paid for each office visit or treatment rendered–not for keeping a patient healthy, Bechtel explained.

“Right now, we pay for health care largely using a fee-for-service program,” Bechtel said. “It tends to reward doctors who do more but not those who do better.”

Ricciardi said legislators should consider introducing policies that help doctors pay to get e-health technology started in their offices.

Increased Efficiency

Many doctors who have incorporated e-health into their practices have eventually seen financial benefits, in part because the increased efficiency allows them to see more patients.

“If you talk to the physicians who have adopted, they’ll wish they would have done it sooner,” Bechtel said. “It was challenging, it required a lot of time and resources,” she explained, but many doctors conclude the initial cost paid off.

Nevertheless, the expense of switching to e-health remains a significant barrier for many providers, Bechtel said.

Privacy issues have kept consumers from switching to personal electronic health records that could be shared with their health care providers, Ricciardi said.

Privacy Framework Lacking

Many corporate and legal privacy policies have not yet addressed e-health developments.

“Right now, there really isn’t an overarching privacy framework,” Ricciardi said.

Consumers can help the transition to better records by buying and using personal e-health records, Ricciardi noted.

“You can start by just trying to pull together your own information, and let your doctor know that it is a priority,” Ricciardi said.

Meanwhile, both Ricciardi and Bechtel suggested, legislators should examine the current payment system and work on providing physicians’ practices with incentives to switch to e-health records.

Jillian Melchior ([email protected]) writes from Michigan.