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Physicians
Welcome Increased Role for the Internet |
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This
information contained in this article is the result
of the survey, "Internet Use by Medical Groups"
conducted by Harris Interactive on behalf of the
Health Technology Center (HealthTech) in cooperation
with PricewaterhouseCoopers and the Institute for
the Future. |
The Internet is transforming medical practice for
physicians far more rapidly than most industry observers
thought possible, according to a recent survey (November
2000 through January 2001) conducted for the Health
Technology Center (HealthTech) by Harris Interactive in
cooperation with PricewaterhouseCoopers and the
Institute for the Future (IFTF). The survey, which
polled physician leaders and office-based practicing
physicians in medium and large practice organizations,
found widespread agreement that computers have already
had a positive impact on the practice of medicine and
quality of care.
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, with
96% of those surveyed agreeing 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.
Despite the Institute of Medicine's (IOM) 1999 patient
safety report recommendation 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:
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."
Copies of the Survey Toplines and Chartpack are
available online at
www.healthtechcenter.org or by calling HealthTech at
(650) 233-9576.
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 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. 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.
---The Frabotta Company
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