published Tuesday, February 24th, 2009

Chattanooga: Doc: No paper, no scissors

by Emily Bregel
Audio clip

Antoine Agassi

At Chattanooga-based Digestive Health Associates, the switch to electronic medical records a year and a half ago was by no means a breeze.

Scanning and inputting data from 3-inch-thick medical records on all the practice’s patients was time consuming to say the least, group workers say, and the initial startup costs totaled more than $100,000 for the three-doctor practice.

That’s on top of a couple of months in which the practice had to cut the number of patient appointments by 20 percent to allow office workers and doctors to learn the new system, office manager Julie Brooks said.

But the savings on overhead costs, transcription fees and the new office efficiency has made the effort well worth it, she said.

“It’s a labor-intensive move ... but it’s the best thing we ever did,” Ms. Brooks said.

While most doctors agree that massive amounts of paper records are costly and cumbersome to their practices, for physicians operating on tight profit margins the huge financial and time investments needed to make the switch to electronic records can be prohibitive.

“There’s a smaller margin now for doctors, as far as making ends meet,” said Dr. Donald Hetzel, a gastroenterologist with Digestive Health Associates. “That’s where the big hesitancy is — it can get pretty expensive.”

Under the recently signed federal economic stimulus package, $19 billion has been set aside to encourage adoption of health technology. Doctors’ practices and hospital systems could get hefty financial incentives for “meaningful” use of electronic health records, and providers who do not implement a paperless records system in the next five years would face penalties of lower Medicare reimbursements.

In recent years, the state of Tennessee and Gov. Phil Bredesen have directed funding and launched programs to promote health information technology, such as electronic medical records and electronic prescribing of medicines.

An electronic medical records system helps prevent errors and redundant tests by compiling all patient data and medical histories in one place and streamlining a practice’s operations, supporters say.

White’s Pediatrics in Dalton, Ga., has had an electronic medical records system in place since the mid-1990s, said Dr. Jeffeory White, founder of the practice.

The initial investment of more than $100,000 for the practice has long since paid for itself, Dr. White said. He said he decreased his staff by half when he no longer needed those employees whose sole role was to file and seek out patients’ paper records.

“It’s saved me so much time and money, it’s incredible,” he said.


Not everyone is in favor of electronic medical records now, including Sue Blevins, president of the Washington, D.C.-based Institute for Health Freedom, a nonprofit group focused on patients’ freedom to choose their health care and maintain their privacy.

She said the patient privacy regulations in the Health Insurance Portability and Accountability Act already are weak and need to be strengthened before all paper records are digitized and thus more easily shared.

“We’re not against the technology. I like using an ATM machine,” she said. “But when it comes to health care, you’re talking about a whole ’nother issue.”

A February report from the Institute of Medicine concluded that HIPAA laws should be improved to accommodate electronic medical records.

To date, the definition of a true electronic medical record is still “nebulous,” said Russ Miller, senior vice president for the Tennessee Medical Association.

A paper medical record that has been scanned and uploaded into a computer is technically an electronic record, but the key to a meaningful electronic medical records system — one that could improve patient care and reduce redundant tests — is the easy exchange of that data between a patient’s various providers, Mr. Miller said.

state efforts

Over the past few years, Tennessee has awarded 1,830 “connectivity grants” to doctors to help them pay for discounted access to the state’s own high-speed broadband Internet connection, which would facilitate their move to e-medical records, said Tennessee Department of Finance and Administration Commissioner Dave Goetz.

The funding for those grants now is exhausted, but stimulus money may help with that, said Antoine Agassi, chairman of the Tennessee eHealth Advisory Council created by Gov. Bredesen.

Health information exchange Shared Health, a wholly owned subsidiary of BlueCross BlueShield of Tennessee, gives physicians access to patients’ digital medical information gleaned from insurers’ claims data as well as input from a patient’s doctors.

The health information exchange now has the medical information for 3 million Tennesseans in its database, said Shared Health President and CEO Jana Skewes

“Physicians tell us they can see at a glance that broader patient view so they can improve their continuity of care,” she said.

Melissa Portera, financial manager for Chattanooga Surgical Oncology and Associates, is hopeful that the stimulus package signals an understanding of the burden doctors face in implementing such a system. She estimates it would cost $50,000 to go paperless in her offices and, for now, the option is out of reach, she said.

“At least they seem to recognize that it is an expense, that if the government’s gonna require it, they need to help with (paying for) it,” she said.

about Emily Bregel...

Health care reporter Emily Bregel has worked at the Chattanooga Times Free Press since July 2006. She previously covered banking and wrote for the Life section. Emily, a native of Baltimore, Md., earned a bachelor’s degree in American Studies from Columbia University. She received a first-place award for feature writing from the East Tennessee Society of Professional Journalists’ Golden Press Card Contest for a 2009 article about a boy with a congenital heart defect. She ...

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Brittanicus said...

The only way the American taxpayer will see a turnaround in some of the economy is to halt immigration violations. It has become a combat zone in the workplace. This simply means we need State governors, mayors, judges and anti-illegal immigrant, pro-sovereignty politicians. Starting with Walter Moore, as a new Mayor elect of Los Angeles, who would rescind the 'Sanctuary city' policy in the county.

Only THE PEOPLE, have the power to recall or reject incumbents like Sen. Harry Reid (D-NV), Speaker Pelosi (D-CAL) who undermined e-verify in the Stimulus package.

A powerful tool to halt foreign nationals taking jobs of American workers. 40 million illegal aliens have occupied our country, according to the Heritage Foundation. Not 13 million pushed by the liberal media Different administrations have allowed this, in favor of the business community and it's likely to get worse as foreign country economies suffer. The stimulus bill promotes upgrading roads, bridges and other infrastructure.

Whistle-blowers should report contractors to ICE, who violate immigration laws.

Do not stop calling the Washington switchboard demanding reinstating (202) 224-3121 This is also your contact with President Obama to stop hundreds of billions of dollars that support illegal immigration.


February 24, 2009 at 2:36 p.m.
HernandezUSA said...

Rosemary Jenks, the lawyer who heads up NumbersUSA's Capitol Hill Team, has repeatedly and publicly issued a challenge to the media and open-borders advocates to produce even one example of an American losing a job because the E-Verify system wrongly ordered it.

If it turned out that of millions of transactions a year, there were 10 or 20 mistakes, we would be concerned but also find that to be an understandably tiny problem.

But, to date, opponents have NOT BEEN ABLE TO FIND an example of even ONE AMERICAN who lost a job due to problems with E-Verify.

A government investigation of E-Verify in 2007 found:

93% of employees queried through the system were verified within 5 seconds!

another 1.2% were verified within 24 hours with no additional action required of either the employee or the employer

Most of the 5.8% who received a tentative non-confirmation requiring more time turned out to be illegal aliens

only 0.5% were U.S. citizens or authorized foreign workers who had to contact the Social Security Administration because of errors in the database

And let's be clear about that 0.5%. Many of the errors were ones that the workers themselves had made, such as a woman not notifying SSA of a change in last name after a marriage. And even if the error was the government's fault, going through E-Verify was a positive experience for most because they needed to know the error existed so they could clean it up before it caused problems down the line.

The 2007 study found that the accuracy rate of E-Verify was 99.5%.

Can any government program anywhere claim such a record?

And what the critics miss is that the system is set up so that when there is an error, nobody loses a job or is temporarily suspended from a job. The rules require that an employee who gets a tentative non-confirmation will continue to be employed until clearing up the discrepancy. (The illegal aliens, however, typically just don't show up for work after getting the first non-confirmation.)

An independent study between April and June of 2008 by Westat found:

96% of employees were verified instantly

0.4% had to contact the government to resolve record errors

3.5% received final non-confirmations, meaning they were illegal aliens not having the legal right to work

Nearly every reporter in the mainstream media allows open-borders leaders to be quoted saying the E-Verify databases are full of errors that lead to all kinds of mishandling of employees, but the reporters don't allow the statistics above to show up in their stories. The claims about errors are lies, pure and simple.

February 24, 2009 at 6:57 p.m.
rolando said...

What's with you two posters? Don't you know both sides of the aisle in both houses of Congress as well as the President do NOT want to hear that kind of stuff. It flies in the face of everything they tell us about how good and wonderful the sweet "undocumented workers" and their adorable families are, to say nothing of their hardworking, tax-paying and law-abiding nature.

Yeah, right.

February 24, 2009 at 9:33 p.m.
Whimsie said...

We must have E Verify to help weed out illegal aliens who are taking the jobs of the American people and stealing services, including medical through fraud and stolen identities. The billions that illegal aliens take within the United States and the billions that they send out of the United States are desperately needed now. The crimes that they commit, the gangs, the drugs, the smuggling, the murder, rape, drunk driving needs to follow them to their own countries and be dealt with by their governments.

February 27, 2009 at 10:13 p.m.
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