Stimulus incentives has docs going digital: But penalties await those who cling to paper

TRAVERSE CITY – Digital clocks. Digital cameras. Digital television. In this high-tech era, everything is going digital. That might soon include your health records.

In February, President Obama signed the stimulus bill into law. This bill includes monetary incentives to help the medical field make the transition from paper files to computer records. Local doctors' offices that participate in Medicare and Medicaid are eligible for up to $64,000 to make the switch, payable as "bonuses" in their reimbursement checks. Starting in 2011, the money will be given out to doctors who can show meaningful use of an Electronic Medical Records (EMR) system. There are also financial penalties for doctors who don't modernize within five years.

It's a big undertaking because, according to the Centers for Disease Control and Prevention, only 38 percent of doctors used some sort of EMR last year.

With EMRs, the days of hospitals trying to track down your primary physician for important medical history will be a thing of the past. Instead of your records sitting in a file cabinet, they will soon be stored on a secure computer site.

"If a local patient is in a serious car accident in London and can't speak, this system can speak for them," says Dr. Don Caraccio of Thirlby Clinic in Traverse City. "An EMR is like a virtual medical paper file that follows you wherever you go."

Several doctors' offices around the Grand Traverse region aren't waiting for the deadline. They've already started using a partial EMR system. Thirlby Clinic, for example, uses a combination of both electronic and paper files. Through the EMR system, the clinic is able to communicate with Munson and other local doctors' offices, sharing information such as laboratory or mammogram results. Dr. Caraccio says the clinic's goal is to go as paperless as possible in the next few years.

"It just makes sense to move in this direction," he says. "Along with improving the quality and delivery of care, it can also save a lot in health care costs."

Many health experts say EMRs help control costs by eliminating duplicate tests and catching problems like allergies and dangerous drug interactions faster than before.

Perhaps more importantly than saving money, EMRs can also improve patient care. Grand Traverse Heart Associates has started using computers to help read medical tests, and has already seen life-saving results.

"One of the GTHA physicians was able to review a cardiac image via a secure remote link and provide recommendations that ultimately saved the patient's life," says Project Management Consultant Barbara Cunningham. "I can think of no greater purpose than touching and benefiting the lives of those in our community."

GTHA has recently begun the process of going digital. The first step is to computerize scheduling and billing tasks. Eventually, the system will be expanded to include online prescriptions and provide doctors and nurses with portable computers for note-taking. Their notes will then be uploaded into a secure network, and be available in any exam room. Cunningham says the future can be summed up in one sentence:

"It's all very high-tech and cool!"

While some local doctors are just starting the process of going digital, others have completed it. Creekside Clinic and Sports Medicine Institute in Traverse City no longer uses paper charts after installing an EMR system three years ago. The manager of the clinic, who wished to have her name withheld because of her work with other doctors' offices, says the system is convenient for both doctors and patients.

"All of our labs and most of our tests and prescriptions are ordered electronically. The physician can access the EMR chart from home through a secure VPN (virtual private network) link. Patients should be assured that their information is secure and remains private."

While there is a lot of support for EMRs, there are also concerns about privacy and confidentiality. Critics say the idea that personal medical information is available in cyberspace is unsettling. They point to dangers like the recent theft of computer files containing information about 26 million veterans and their families. Dr. Caraccio understands those concerns, but adds that, many times, EMRs can actually be more secure than a paper file.

"With EMRs, you have a dedicated set of eyes looking at a secure-access computer site." "If you have to fax a paper medical record, a lot of people can read that fax."

With all the technological advances inside and outside of the doctor's office, some wonder if visits to the doctors will soon be replaced by a "virtual visit." Dr. Caraccio doesn't think so.

"There will always be a need for face-to-face interaction," he says. "I don't want to be examined by a computer, and I'm sure my patients don't want to either." BN