Headline June 12, 2016/ ''' TECH PAYOFFS : MOAN & BEMOAN '''

''' TECH PAYOFFS : 

MOAN & BEMOAN '''

SINCE THE FINANCIAL CRISIS, the Obama administration has moved aggressively to push medicine into the digital-age.

As part of the economic recovery package, Congress enacted the Health Information Technology for  Economic and Clinical Health Act of 2009. the legislation provided for federal incentive payments of $44,000 a Physician to shift to electronic health records.

The billion of dollars in subsidies were intended to accelerate adoption. and from 2008 to 2014, the share of hospitals with electronic health records rose to-

75 per cent from 9 per cent, while the adoption rate in doctors' office rose to 51 per cent from 17 per cent, according to the most recent surveys by the American Hospital Association and the government.

''The government funding has made a huge difference,'' said Dr Ashish K Jha, a professor at Harvard University's T.H. Chan School of Public Health.

'' But we are seeing little evidence so far that all this technology has made much effect on quality and costs.''

The electronic records, health experts say, represent only a first step toward curbing costs and improving care. '

'People confuse information automation with creating the kind of work environment where productivity and creativity can flourish,'' said Dr. David J Brailer, who was the national health technology coordinator in the George W Bush administration. ''And so little has gone into changing work so far.'' 

The government incentives came with time tables for adopting different timetables for adopting different levels of use and new reporting requirements, with the prospect of financial penalties-

For doctors and hospitals that fell behind. The early goal for adopting electronic records were reasonable, health experts say, but the later stages were too aggressive.

Overwhelmed the doctors protested, and the administration recently shelved the previous timetable, stretching out schedules and modifying some reporting rules.

Healthstar Physicians, the 50 doctor group in Morristown, Tenn; where Dr Sutherland practices, was spurred to go electronic by those federal payments, which now total $32 billion. But the cultural adjustment to digital technology has been challenging.

Dr Sutherland and his colleagues evaluated several technology providers and chose Athena Health, which does not sell software but is paid a percentage of its customers' revenue. 

Healthstar started using Athena's  Cloud software in 2012, fist for billing and then for electronic health records. Athena's share is less than 5 percent of the group's revenue.

Today, Dr Sutherland's personal income and the medical group's revenue are about 8 percent below where they were four years ago.

But in 2015, both his earning and the revenue of Healthstar, which employs 350 people in 10 clinics, increased slightly, by nearly 3 percent from 2014.

Dr Sutherland decided he did not want a computer screen separating him from his patients. So he opted for a tablet computer, making it easier to keep eye contact.

Not being a fast typist, Dr Sutherland decided to use  voice recognition software. For six months, he stayed up until midnight most nights, training the software until its speech recognition engine could transcribe his comments into text with few mistakes. 

Dr Sutherland bemoans the countless data fields he must fill in  to comply with government mandated reporting rules, and he concedes that some of his colleagues hate using digital records.

Yet Dr Sutherland is less negative. despite the extra work the new technology has created and even though it has not yet had the expected financial payoff, he thinks it has helped him provide better information to patients. 

He values being able to tap the screen to look up potentially harmful drug interactions and to teach patients during visits. 

He can, for example, quickly create charts to show diabetes patients how they are progressing with treatment plans, managing blood glucose levels and weight loss.

He is working harder, Dr Sutherland says, but he believes he is a better doctor. blunt measures of productivity, he added aren't everything.

''My patients are better served,'' he said. ''And I am happier.'' 

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