If I understand correctly though, the EMRs that GPs in the UK purchased in the 90s had a slightly cheaper price tag – especially in comparison to the % of a practice’s operating revenue.

I was particularly interested to read this line from the interview:
“Patients are registered at a particular practice, which usually contains five to 10 physicians, equating to 6,000 to 12,000 patients per practice.”

I would imagine a practice in the UK with 5-10 GPs and 6-12k patients has a much larger capital budget for acquisitions than a 1 or 2 doc practice in the U.S.

Considering that about 30% of U.S. physicians still practice in a 1 or 2 doc practice, I just don’t see how they are going to be able to raise the necessary capital to purchase a top of the line EMR product or take the productivity hit while they learn to become proficient on the EMR system over 9-12 months.

So it was interesting for me to read more specifcs about the system.

My daughter and her family are moving to Washington, DC in March and will be shopping for healthcare insurance. Is she in for a shock!! First shock will be the cost of the policy/co-pays and the accompanying coverage limitations. Good luck finding a PCP who is accepting new patients. I’m sure there will be lots of grumbling about our American healthcare system.

If you think this is oversimplified, then wake up and smell the digital roses. I am very disgusted that we can even implement ICD-10-CM codes without chaos and AHIMA anarchy. The excuses are myriad in number and implementation was been pushed back until 2009. I am a renaissance medical informaticist tying to pull it all together in a unified federated view of healthcare universe and I am loosing ground. Thanks to Dr. O’Hanlon’s interview, there appears to light across the pond.

Very interesting point; I had not associated the adoption of EMR’s with the fact that they are “free”; Virtually all UK GP’s (Primary Care Physicians) purchased their own EMR’s during the late 90’s (some got partial reimbursement) and that purchase was a business decsion based on the improvements in scheduling, ordering, prescribing afforded by the EMR – alongside the recognitition that paper notes were becoming increasingly bloated and difficult to manage.

Once installed, the physicians realsied that with pathlinks and a decent noting tool, they could dispense with paper (99% have) and started to produce their own EHR’s…..when the CMS programs came along they already had most of the processes in place to adapt to them and the data to fulfil them.

The EMR purchase therefore paid for itself in terms of physician time and staff costs.

Only recently have they been made “free” – part iof a contractural agreement between the GP’s and the government – but I doubt many would stop using them if they had to start paying for them again.

Happy to correspond off line if you wish

Cheers

Shaun

My key takeaway from all of this – the UK has already moved to pay for performance in a big way (20% of a GP’s compensation) and this is where CMS is likely to go in the near future. The only difference is that the gov’t in the UK paid for the EMR systems physicians are using.

Given that the likelihood of the U.S. federal gov’t making widespread funding of EMRs nearly 0%, the question is how are U.S. physicians (particularly PCPs and docs in small practices) going to pay for this. Tax credit or tax cut? That is the 64k question.