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Early-adopter docs tout merits of digital records

Paperless physicians say better patient care outweighs IT costs

Dr. Donald J. Cinotti, an ophthalmologist and president of the Medical Society of New Jersey, said despite the large costs associated with switching to electronic records, it's now easier for his seven-physician practice to find tests without duplicating services. Cinotti is pictured with assistant Danielle Traina in the Jersey City office.

In the Summit Medical Group’s battle against diabetes, electronic medical records are playing a critical role, according to its chief medical officer, Dr. Robert W. Brenner.

In the Summit Medical Group’s battle against diabetes, electronic medical records are playing a critical role, according to its chief medical officer, Dr. Robert W. Brenner.

The nearly 200-physican group in Berkeley Heights had largely made the switch from paper to electronic charts when Brenner came on board in 2006. He pushed the group totally paperless, and in 2007 oversaw the creation of a computer registry of the group’s 2,000 diabetics.
Back then, about 9 percent of diabetics were achieving a clinical benchmark for diabetes management — about the state average. Today, that number is between 18 and 20 percent, said Brenner, who credits digital records with the improvement.

Electronic records make it easy to identify diabetics, “and then we make an intervention,” he said, using the group’s call center to reach out to diabetics and remind them to make and keep doctors’ appointments. “You can’t do this easily without electronic health records.”
Summit is among several hundred New Jersey medical practices in the digital vanguard, but many are just starting the expensive and difficult switch from paper. Later this year, Medicare and Medicaid will make incentive payments to doctors who demonstrate they are making “meaningful use” of digital records — and the government has told doctors to expect a reimbursement penalty in the future if they don’t go paperless.
But Brenner said better ways of practicing medicine — and, ultimately, healthier people — are the real payoff from electronic records.

And he’s not the only early adopter who feels that way. Dr. Donald J. Cinotti, an ophthalmologist and president of the Medical Society of New Jersey, said his seven-physician practice went digital a decade ago, at an investment of more than a half-million dollars, plus about $25,000 in annual IT expenses for hardware updates and software licenses.

But despite the costs — which Cinotti said mostly aren’t covered by either federal incentives or insurance reimbursements — “there are a lot of good things about computerized records,” he said. “The promise is that patients will get better care and less duplication of services,” with lab reports easier to find and routine tests simpler to schedule.

Sandra Regenye, billing manager for Horizon Eye Care, said the practice went paperless more than eight years ago; its eight doctors work in a surgery center and six South Jersey offices. She said electronic drug prescriptions “will reduce or eliminate drug interaction” risks: Patients are always asked to list their current prescriptions, but sometimes, “the patient doesn’t remember” them all. She said Horizon Eye’s doctors can access all patient records, regardless of which office they visit, “and the doctors can review records at home; (the records) are not sitting in the office.”

And Susan E. Reed, director of the health care industry service group at the Clifton CPA firm Sax, Macy, Fromm, said “a big misconception” was that digitizing records would “eliminate staff, and that is not the case.” Instead, staffs are retrained to work in the new digital environment, and larger groups need an IT department: Reed said one of her client practices spends about $75,000 a year on IT.

Cinotti said he foresees a day when patient histories “will be put on a disk or thumb drive, and the patients can carry their medical history around wherever they go.” And while experts say individual health records will eventually be archived online, New Jersey’s full medical conversion to digital will take years, in part because most of the state’s 30,000 licensed physicians work in solo or small practices, and have more difficulty than larger groups to find the time and money to computerize.

In Horsham, Pa., NextGen Healthcare is providing digital records systems to about 5,000 New Jersey doctors, according to Charles Jarvis, vice president.

Jarvis said Medicare could begin making incentive payments to some New Jersey doctors as early as May, which “should help stimulate more doctors to make IT purchases.” He said the switch to digital causes doctors to experience a short-term dip in productivity, but the benefit “is a more timely capture of information and quicker diagnosis.”

Doctors “can quickly analyze results from diagnostic tests and match them up with their own examination,” he said, and “instantly communicate with a referring physician or a lab or radiology, leading to more effective and timely delivery of care.” As patients create their own personal health records, “they can communicate with the physician after a visit, and before the next visit. This kind of interactive care leads to the patient being more involved” in their own health, he said.

E-mail to: bfitzgerald@njbiz.com

Beth Fitzgerald