While insurance companies are getting behind greater electronic communication among doctors and their patients by paying for such care, Partners HealthCare System is forcing the use of electronic health records on the physicians in its community network.
Primary-care physicians who have not implemented or agreed to implement an EHR by Jan. 1, 2008, are out of the Partners network, said Tom Lee, chief executive officer of Partners Community HealthCare, the physicians network of the Boston-based hospital system. The implementation of EHRs throughout the physician network will allow information across the system to flow in a timely and more efficient manner, he said.
"We did it with a lot of care and thought; if you're going to be one of us, this is the criterion," Lee said. Partners hasn't lost any doctors yet as a result of the decision, but some physicians are complaining about the change. Lee said he recognizes that the mandate seems "tough." He added: "Believe me, some of (the doctors) are mad."
Partners expects to lose 15 to 20 primary-care physicians this year because of the mandate, and could lose some patients if those doctors stop referring them to Partners hospitals, Lee said. The Massachusetts-based hospitals in the system include 746-bed Brigham and Women's Hospital, 90-bed Faulkner Hospital and 902-bed Massachusetts General Hospital, all in Boston; 233-bed Newton-Wellesley Hospital, Newton Lower Falls; 169-bed McLean Hospital, Belmont; and 417-bed North Shore Medical Center, Salem; as well as rehabilitation institutes and research centers.
The board's decision, made in March, was not just about electronic records—Partners is striving for even higher performance and outcomes from its hospitals, and using EHRs is one way to improve efficiency. "We're asking people if they want to go down the road of really integrating their care with colleagues," Lee said.
There are about 5,000 doctors in the Partners network. The primary-care doctors have until the end of 2007 to implement either Partners' EHR or one created by GE Healthcare. If they don't have the EHR but sign an agreement to implement one in 2008, they will retain their network status. At this point, specialists have through 2008 to implement an EHR, but by Jan. 1, 2009, any physician still not connected is out of the network.
Mohammed Akbarian, a cardiologist in the community network, said in time, doctors won't have a choice about EHRs because the industry is moving in that direction. However, doctors are not convinced that the initial cost and training time will improve their overall business. "Eventually, it will be worth it," he said, "but no one's dying to get one."
Mario Motta, another cardiologist in the network, called the mandate a "two-edged sword." Motta, who uses Partners' EHR, said that there is a benefit to having an EHR because insurance companies reimburse at higher rates for their use; however, the health system is not financially supporting their physicians to implement them. "They (physicians) are being asked to carry the freight," he said.
Funds are available to improve Partners' EHR system and to train doctors on it, Lee said.
This story initially appeared in this week's edition of Modern Healthcare
magazine.
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