Less than 1% of community-based physicians had access to any form of electronic medical record by the middle of 2002, compared with 38% of physicians in academic or staff-model practice, according to AC Group, a Spring, Texas-based healthcare research firm.
The American Academy of Family Physicians hopes to change all that.
The family medicine society is in the midst of a search for a low-cost EMR that it hopes to make available to its nearly 94,000 physician members and other office-based practitioners.
"The academy has had an interest in our members adopting electronic health records, but we have been very disappointed with what is available commercially," says David Kibbe, M.D., director of health information technology for AAFP and a medical professor at the University of North Carolina. Kibbe also is president-elect of the North Carolina Healthcare Information and Communications Alliance and chairman and founder of Canopy Systems, a hospital care management software company in Chapel Hill, N.C.
Kibbe cites high costs of existing EMR software and questions about whether small vendors will still be in business in the future.
"Our members are already asking for this application," Kibbe says. "There is significant pent-up demand. You can think of this as something that came from the trenches."
He says he gets three to 10 e-mails each day in support of the project.
Plans call for developing the EMR using open-source software, which has no licensing fees, making it cheaper to distribute and maintain. (The freely available Linux operating system is one well-known example of open-source software.)
Last month, the AAFP announced a plan to further its goal of offering application service provider-type EMR service through the Web for no more than $150 a month, including training and support. They aim to create a system that is able to work with the existing clinical and practice management systems in their members' practices.
The program, one piece of the AAFP's Future of Family Medicine initiative, will focus on small primary care practices and on creating a standardized EMR even as the massive HIPAA administrative simplification regulations fail to define a medical record.
The AAFP is putting together a group of primary care specialty societies, healthcare industry and government representatives-tentatively called the Health Information Foundation-to develop industry standards for patient records. The Jackson Hole Group of Paul Ellwood, M.D., is a public backer of the project.
"We think they are moving in exactly the right direction, in that it should be an open source and that they are trying to make (the EMR) available to primary physicians at a low cost," Ellwood says.
"I believe it will be the precipitating force for electronic medical records to be adopted throughout the healthcare system."