My physician is a master at getting to the point. So I turned the tables on him. "How come you don't have an EMR?" I wondered aloud. He grinned and said, "We have good reasons and bad reasons." Like most physicians, my internist's group practice is semi-automated, with a practice management computer system and paper charts. They have a barebones Web site (with links to, of all places, Dr. Koop.com of dot-com notoriety!), and under "contact us" reside phone numbers, not e-mail addresses.
This kind of semi-automation has its downsides for patients. Reaching clinicians can be a frustrating exercise in phone tag. And those precarious, well-worn paper charts do not inspire confidence. Dr. G. did not have time to elaborate on the good and bad reasons. But he didn't need to. He and I don't talk about these issues, but I know internal medicine specialists do not have extra cash to burn on an EMR. And the practice runs like clockwork now; they manage to get me into the exam room right on schedule every time.
Now, according to a recent Accenture survey, U.S. consumers would love for their physicians to adopt computerized patient records. Two-thirds of consumers said that electronic health records could figure in their selection of a physician, and half said they'd pay for the service--if the price were reasonable.
If these sentiments are accurate, why not create some mechanisms for consumers to put their money where their cursors are? Nothing as crass as a glass jar for EMR tips, but maybe something as simple as an earmark on our co-pay. Kind of like the check-off box on the income tax form. If you'd like a small portion of your co-pay to help your physician bring your clinical information into the modern era, check here.
Like the people in the survey, I too am willing--theoretically--to select a physician based on his or her technology. However, I'm sticking with Dr. G, paper charts and all. He's just too good a physician. But if a health plan--or somebody--devised a meaningful financial transfer mechanism to help him automate, I'd ante up in a flash.
Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at firstname.lastname@example.org.