James J. Stark, MD
Potential Financial Conflicts of Interest: None disclosed.
Stark J.; Electronic Health Records: Who Pays?. Ann Intern Med. 2006;145:864. doi: 10.7326/0003-4819-145-11-200612050-00014
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Published: Ann Intern Med. 2006;145(11):864.
TO THE EDITOR:
I read with great interest the article by Chaudhry and colleagues (1) and the accompanying editorial by Halamka (2) on the value of the electronic health record (EHR) in improving process and outcome in health care. As a medical oncologist who has seen his practice crippled economically by changes in Medicare reimbursement, and as someone conversant with the problems of internists in keeping their practices economically viable, I wonder who will pay for all of this. Some hospital chains are offering to their staff the cost-saving opportunity to piggyback onto their newly established EHRs. However, software licenses for freestanding practices that are not affiliated with hospitals are likely to be very expensive. Taking old paper charts and transforming them into EHRs will be very labor-intensive and expensive. Unless hospitals develop interfaces with freestanding office practices, the need to manually enter laboratory data and radiograph reports into an EHR will be extraordinarily labor-intensive and expensive. Unless a national EHR is established with links to hospital information and insurance claims systems, many small practices will find that adapting to this new world is difficult to impossible.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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