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Reggi Veatch
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District behind national average for
electronic health record implementation
DOQ-IT Delmarva working with physicians to overcome EHR barriers

Washington, DC, January 12, 2006 - In an age where consumers do practically everything online--from banking and paying bills to making travel reservations--one area that lags behind in adopting computer technology is health care. Within the health care system, the location least likely to use health information technology (HIT) is your doctor’s office. According to a recent study published in Health Affairs (Sep-Oct 2005), fewer than 15 percent of physician practices have implemented electronic health records (EHRs) nationwide.

While it is difficult to measure an exact rate of implementation due to a lack of universally recorded data, it is estimated that the rate of implementation in the District of Columbia falls well below the estimated national average, with only approximately five percent of all District physician practices having fully computerized medical records. That means the vast majority of doctors in the District of Columbia still rely on pieces of paper stored in filing cabinets. Not only is all this paper increasingly hard to keep track of, it represents a significant barrier to improving patient safety.

Why the District of Columbia is behind the curve when it comes to EHR may be attributed to several factors. There is currently no organized District-wide coalition to promote and support EHR adoption. The Maryland State Legislature has recently passed legislation to form a statewide task force on electronic health records, which is under development and has yet to hold its first meeting.

The rate of EHR implementation can also be traced to the demographics of the local physician population. EHRs tend to be adopted earlier by larger groups of physicians because they have the economic and organizational resources available. Also, larger physician groups are more likely to be able to capture savings and to realize efficiencies that might not be available to smaller practices. In the District, physicians are much more likely to practice as solo practitioners or in groups of two to three.  They are far less likely to possess the resources and expertise necessary to assess and invest in an electronic health record.

Delmarva Foundation, Medicare’s Quality Improvement Organization in the District of Columbia, has begun a three year program called DOQ-IT (Doctors’ Office Quality-Information Technology). This program is aimed at helping smaller practices close the gap and overcome the major barriers to EHR implementation. The program provides free technical assistance and support to physicians and their staffs in order to accelerate the adoption of HIT in the District of Columbia. DOQ-IT, funded through Delmarva’s contract with the Centers for Medicare & Medicaid Services (CMS), is recruiting small to medium-sized adult primary care physician practices. In addition to the adoption of EHRs in these offices, DOQ-IT Delmarva goals include the implementation of safe practices such as e-prescribing and clinical decision support, increased physician access to patient information and improved communication between physicians and patients.

“Through the DOQ-IT Delmarva program, we want to help move medicine in the District of Columbia forward so that all District doctors have the opportunity to deliver the highest possible care to their patients in the most efficient manner possible,” said Dr. Michael Tooke, DOQ-IT Delmarva’s Medical Director. “The most important benefit to physicians and patients alike is the ability to deliver the right care to every patient, every time. Electronic health records will be a significant factor in achieving that benefit.”

Delmarva is currently working with practices to help physicians and their staffs identify which of the numerous available computer systems is the best fit for their practice’s needs.  Through DOQ-IT, physicians will also have access to expert technical assistance to streamline the workflow of their practices, enabling them to realize fully the benefits of EHRs.

Peter Basch, MD, a physician with MedStar Health and an early implementer of an EHR system, makes an important point when talking about EHR, "The thing to remember is that physicians need to transform the way they provide care, and not just look to a computer to improve quality. The goal is better health care, not simply better data management."

Delmarva Foundation does not endorse any particular EHR vendor but is available to provide guidance to participating practices in implementing and using EHRs.  These services and resources are provided to physician offices free of charge. For more information or to sign up for DOQ-IT, apply online at www.delmarvafoundation.org/doq-it/.

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About Delmarva Foundation
Delmarva Foundation is a national, not-for-profit organization dedicated to improving healthcare quality in over 20 states. Since 1973, Delmarva has assisted in improving care in hospitals, nursing homes, home health agencies, medical practices and health plans. Delmarva performs quality improvement, quality assurance, utilization review, external quality review and Program Safeguard activities. The company's corporate headquarters are located in Easton, Maryland with other offices in Baltimore, Maryland; Washington, DC; Columbia, South Carolina; Tampa, Florida; and Tallahassee, Florida. For more information, please visit Delmarva Foundation on the web at www.delmarvafoundation.org.