California HealthCare Foundation and First Consulting Group publish guide for IT-challenged doctors' offices

Oakland 03 September 2002Information technology (IT) strategies that work for the small physician office are finally emerging as traditional barriers like cost and complexity begin to diminish, according to a newly published report by the California HealthCare Foundation (CHCF) and First Consulting Group (FCG). Solo doctors and small physician offices now have access to IT benefits previously affordable only to larger physician groups, according to the study, "Achieving Tangible IT Benefits in a Small Physician Practice".


The report highlights creative new IT initiatives that small physician offices across the United States have developed to improve the quality and efficiency of care. Until fairly recently, the success stories of small physician practices implementing IT beyond billing functions have been few and far between. A variety of factors are driving the change, including Web-based technology and widespread access to the Internet, which has allowed vendors to offer remotely hosted applications that simplify the task of managing technology.

Some vendors now offer IT via the application service provider (ASP) model, which spreads the system costs over time. Other factors encouraging small doctors' offices to adopt IT involve:

  • The advent of mobile computing devices enabling a better fit with the work style of the physician without large costs for equipment wiring.
  • Some vendors now offering modular, tool-based products that provide options for adding functionality incrementally.
  • Many vendors designing products that make interoperability, the ability to integrate different systems, and data transferability from one system to another, less problematic.
  • Vendors reconfiguring their products and pricing models to meet the needs and budgets of small practices.

Case studies included in the report describe an orthopaedist who uses an automated appointment reminder system to call patients the day before their visits; a urologist who documents clinical notes with a Web-based notewriter; and a solo practitioner who self-installed an electronic medical record that cuts practice costs by 20 to 30 percent per patient visit.

"The small physician practice is a difficult venue for implementing IT-enabled patient care", stated Thomas Lee, M.D., M.B.A., senior programme officer at CHCF. "This report shows that innovative physicians are making important steps to improve the quality and efficiency of patient care by using information technologies that are becoming more available in the marketplace."

The research conducted for the report sought to identify the spectrum of IT approaches in use in small practices today and to demonstrate through case studies that physician use of IT can and does produce qualitative and quantitative benefits. "Most patient care occurs in outpatient settings like the small physician practice", commented Keith MacDonald, a senior research manager in FCG's Emerging Practices unit and an author of the report. "As consumers, we are all aware of the need for better efficiency in that setting. Clearly, the landscape is changing quickly to make that happen."

Physicians and staff at more than two dozen small physician practices were interviewed, along with vendors and leaders from several national professional organisations. A look across these IT success stories reveals common elements:

  • A specific operational problem that is the target of the IT initiative;
  • A motivated physician interested in IT leading the charge; and
  • A vendor product that represents a good fit for addressing the identified problem.

The case-study lessons are augmented in this report by an overview of available products and their general characteristics. Taken together, this report can serve as a guide for the small physicians eager to find IT solutions for the challenges in their practices.

CHCF is an independent philanthropy committed to improving California's health care delivery and financing systems. Its goal is to ensure that all Californians have access to affordable, quality health care. CHCF's work focuses on informing health policy decisions, advancing efficient business practices, improving the quality and efficiency of health care delivery, and promoting informed health care and coverage decisions.

The First Consulting Group is a provider of consulting, technology, and outsourcing services for health care, pharmaceutical, and other life-sciences organisations throughout North America and Europe. The firm's services increase clients' operations effectiveness, resulting in reduced costs, improved customer service, enhanced quality of patient care, and more rapid introduction of new pharmaceutical compounds.

Copies of the report and other publications in the iHealth Report series, including the new report on using IT to address the goals of the Institute of Medicine II Report, "Crossing the Chasm with Information Technology: Bridging the Quality Gap in Health Care", can be obtained by visiting the California HealthCare Foundation on-line. The iHealth Reports series focuses on emerging technology trends and applications related to policy and regulatory developments.

Leslie Versweyveld

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