I have commented frequently on the physician’s office practice as being the last bastion to electronic records, due to the wide range of acceptance and implementation of electronic health records, including imaging. Granted there are some very sophisticated practices out there that have fully embraced the technology. However, for every group that has, there are probably a dozen more that haven’t, for a variety of reasons.
Unless the physician happens to be a techno-geek who also happens to practice medicine, the reality is that they probably don’t have the time or ability to manage the technology in their office. They instead sometimes take the path of least resistance, and avoid it until it is either attractive or forced on them. The old adage “if it isn’t broken, don’t fix it” may be very apropos.
Looking across the physician’s office practice, there may be multiple systems in use. Most likely, the office manager is more attuned to them, and involved in their management. Depending on the background of these personnel, there may or may not be effective IT policies and practices in place. A key area of concern is data backup and disaster recovery. As more and more systems go electronic, the challenge will grow in terms of effective IT management of the data.
Fortunately, a look at current IT technology trends appears to be “just what the doctor ordered” in terms of potential tools that can help the office practice. Furthermore, healthcare legislation might also be an incentive for a dose of IT medicine, as offices struggle with greater amounts of electronic transactions. These prospects are starting to attract some pretty big names to the party. Microsoft, Google, Carbonite and others are looking at healthcare as an opportunity for growth, due to the vast amount of data. In addition, established healthcare entities such as InsiteOne view the physician office market as a likely extension to remote image management and distribution.
In a world of “cloud computing” it becomes very plausible to think of large amounts of patient data being managed for the physician and the patient. Such a strategy offers a number of advantages:
§ Patient mobility – the patient no longer has be worry about transporting their information between multiple physicians and healthcare providers, improving the efficiency and efficacy of referrals.
§ Economies of Scale – the small physician practice may not be able to embrace the technology on their own, and may be incentivized to a lower-cost solution that leverages the cost across a larger group of physicians.
§ Security – Despite internet security breaches, the web can still be a secure means of handling patient data with proper security approaches such as data encryption, making it potentially a more secure environment over today’s paper files.
§ Redundancy – Patient files in a physician’s office are vulnerable to all sorts of attacks, and are usually not redundant in nature, while electronic records can be managed with a degree of redundancy that can reduce the risk of loss.
§ Accessibility –Not only can the physician access the data, but so can the patient. In addition, if there are reasons for specialist consults, it is easier to access the records electronically than it may be to ship the records to the specialist’s office. Also, the records can be accessed at any time, and potentially any place, so if the physician needs access over the weekend, or while away, it would be much easier than being dependent on the office staff for the patient chart.
Therefore, a distinct advantage of the remote management of information is that it provides a degree of redundancy, and places the primary responsibility for backup and disaster recovery on the entity managing the data. This could relieve the physician office staff of having to personally manage such tasks and allow them to concentrate on what they do best – practice medicine.
One might argue that the cost for remote management of the data would be higher than a local application, but one must also take into account the capital and personnel costs associated with maintaining an on-site application. These are important factors in the justification of remotely managed data.
As for justification, the precedent has already been set with physician accessibility of images via web access to imaging facilities. The data is stored by the imaging facility, but may be accessed any time by the physician/office staff.
Perhaps one of the biggest drawbacks to its implementation will be support. As large organizations get into the business, they may already have extensive support infrastructure that can be leveraged. One might envision a web-based application with only peripherals located locally. Following initial installation and training, all support could be managed remotely. Such an approach might make it more palatable if the physician group knew it didn’t have to manage the application, or the maintenance of the data.