Study Finds Physicians Seeking Technology
March 20, 2001 -- The Internet is transforming medical practice
for physicians far more rapidly than most industry observers thought
possible, according to a recent survey. Respondents agreed computers
have already had a positive impact on the practice of medicine and
quality of care.
Conducted for the Health Technology Center (HealthTech) by Harris
Interactive in cooperation with PricewaterhouseCoopers and the Institute
for the Future (IFTF), the survey polled physician leaders and office-based
practicing physicians in medium and large practice organizations.
More than a third of the physicians and practice leaders consider
a wide range of Internet-enabled core business and clinical services
to be essential advantages. 96% of those surveyed agreed that these
technologies will make the practice of medicine easier and improve
quality of care no later than 2003.
Physicians identified six Internet-enabled services as "essential"
for future success and found value in them because they reduce administrative
costs, speed payments for care, and improve quality of care. The
survey also found that 34% of surveyed physicians and practice leaders
use Internet-enabled sources for information about prescription
medications.
The Institute of Medicine's (IOM) 1999 patient safety report recommended
that physicians adopt automated systems for prescribing. Only 7%
of the survey respondents have done so. Physicians and practice
leaders concurred that the greatest barriers to universal implementation
of Internet-enabled services are a lack of uniform standards for
health information and the inability of current health information
applications to communicate among themselves.
Physicians from the reporting organizations believe that action
by the Health Care Financing Administration (HCFA) or by the major
health plans that would require participating physicians to use
the Internet for administrative services such as claims processing
will be needed to cause rapid migration to Internet-enabled services.
Approaching the Tipping Point
"Physicians are actively seeking to integrate computers and the
Internet into their practices and do not appear to need further
convincing that technology will play an increasingly significant
role," said HealthTech CEO Molly Joel Coye, MD, MPH. Looking beyond
the use of the net for their own news-gathering and research activities,
the applications that respondents indicated had the greatest use
include:
- Diagnostic reporting (34%)
- Claims processing services (35%)
- Pharmaceutical information (34%)
- Purchase of medical office products (29%)
- E-mail communication with patients (29%)
- Electronic medical records (19% indicated they are testing
or have fully implemented EMR)
When asked about the services they considered critical for organizational
success, physicians identified six "essential" Internet applications,
including a mix of administrative and clinical functions. The essential
clinical applications were diagnostic reporting and electronic medical
records. The essential administrative services included claims processing,
eligibility authorizations, referral authorizations, and IT systems
support.
Lee Akay, managing partner for the PricewaterhouseCoopers MCS
Healthcare Practice and co-sponsor of the survey, called attention
to the unique study sample that identified physician leaders (CEOs
or Medical Directors of medical groups) within a broader sample
of physicians practicing in medical groups. "Physicians are increasingly
moving into medical groups that have the organizational capacity
to assess and invest in new technologies. By focusing on physicians
practicing in a group setting, this study more accurately benchmarks
trends in medical practice. These organized physician practices
are moving the industry as a whole toward the "tipping point" in
adopting new technology. This demonstrates that physician leaders
clearly comprehend the tangible benefits of linked networks and
shared data."
Physician leaders cited the lack of data and communication standards
and "real world" applications designed to fit existing workflow
patterns in clinical settings as significant factors slowing the
uptake of technology. Other barriers included the lack of capital
and individual resistance to change. According to Akay, "Current
systems frustrate both patients and physicians with complex paperwork
and medical records that are frequently lost or incomplete. Physicians
are stymied by incompatible systems that cannot "talk" to each other,
and most of all by the absence of industry standards that would
allow vendors to develop applications that link data from disparate
systems. The absence of standardized and compatible services across
the industry makes it risky for individual practices to move to
the next level of Internet-enabled efficiencies and quality improvement."
Clearing the Hurdles
Physician leaders overwhelmingly agreed (93%) that "lack of system
compatibility across healthcare organizations" is a critical barrier
to realization of the full potential of Internet-enabled systems
in medicine. Surprisingly, concern about confidentiality and privacy
ranked sixth among the concerns, with about half of the respondents
rating privacy as only a minor concern.
On the question of who might step in to fulfill the needed integration
and standard-setting, more than two thirds of respondents believe
that the most effective action would be steps by the Health Care
Financing Administration (HCFA) (72%) or major health plans (68%)
to require participating physicians to use the Internet for claims
processing. Only 59% of the responding physicians felt that increased
payment for claims filed via the Internet would be sufficient to
cause rapid, broad-scale change. Coye said, "These results should
provide encouragement to regulators and health plans alike that
the physician community is prepared to respond affirmatively to
well-executed and coordinated plans for widespread Internet-based
healthcare transactions. HCFA is the largest purchaser of healthcare
in the country. These results suggest that HCFA could improve the
coordination of patient care and reduce healthcare costs by supporting
providers in their movement onto the Internet and by making Internet
filing a requirement."
Elaborating on the theme of standards, 93% of physicians and physician
leaders cite industry-wide agreement on standards as an effective
way to drive change and 84% of respondents said it was the "preferred"
way to bring about universal use of the Internet. Physicians would
like either industry associations or health plans to assume the
lead role in vetting a standardized suite of Internet-enabled services
and saw little value in creating a non-profit, government sponsored
organization to sort out these issues. Akay noted, "Recently enacted
Health Insurance Portability and Accountability Act (HIPAA) legislation,
which, among other things, sets standards regarding how providers
communicate with the Medicare program, could be a conduit for accelerated
adoption of industry wide standards. The fundamental key to success
is how quickly and how well those standards are implemented."
Wendy Everett, the director of IFTF's healthcare programs and
chair of the HealthTech board, sounded a note of urgency, "This
study should serve as a wake-up call for all physicians who are
not yet prepared to take advantage of Internet-enabled clinical
and administrative services. These results show that Internet-enabled
medical practice is rapidly approaching critical mass and medical
providers who don't have these capabilities will soon be at a real
disadvantage."
Survey documents in PDF
Methodology
The survey, "Internet Use by Medical Groups" was conducted by Harris
Interactive on behalf of the Health Technology Center (HealthTech)
in cooperation with PricewaterhouseCoopers and the Institute for
the Future. The survey was conducted from November 29, 2000 through
January 10, 2001 with a total of 215 practicing physicians and physician
leaders of medical practice organizations with at least twenty-five
physicians. The surveys were completed online using random samples
of physicians and practice leaders (medical directors and presidents)
of physician practices drawn from the American Medical Association
Group Practice File and the Physicians List.
The survey data were weighted to reflect the composition of the
American Medical Association Group Practice File and the Physicians
List to the following variables: group practice size, region, and
for practicing physicians only, medical specialty.
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