When Dr. B. Dale Magee finalizes his agenda in early 2007, he will encounter a changed political landscape in Massachusetts with the first Democratic governor in more than a decade. No matter, says Magee, president-elect of the Massachusetts Medical Society (MMS). The 225-year-old MMS is used to political change. Its goals don't change, and under Magee's leadership, the push for health-IT adoption is likely to continue.
"Working toward interoperability of information transfer is [one] key for us," says Magee, who takes office in May. "That isn't doable as of today and that needs to happen." Magee is a past chair of the MMS' committee on the quality of medical practice, and according his bio posted at MMS, he focused on electronic health records (EHRs), public reporting of physician data, pay-for-performance initiatives, as well as standards for office-based surgery.
Also on his priority list are education and providing the appropriate tools and management strategies to enable physicians to use health-IT. "There needs to be an effort to educate not just physicians in isolation but also their office staffs so there can be teams in providing effective healthcare," says Magee, a practicing obstetrician-gynecologist in Shrewsbury, Mass.
MMS has already laid much of the groundwork for practical promulgation of health-IT, says Magee, by recommending electronic medical record (EMR) systems from vendors such as eClinicalWorks, Allscripts, e-MDs and NextGen. These offerings generally emphasize applications service provider (ASP) approaches, which are more suitable for small and medium-sized practices without IT support and infrastructures.
In fact, MMS was the first state medical society to endorse an electronic prescription program for its members, signing an agreement three years ago with DrFirst's Rcopia, a complete end-to-end-solution capable of connecting to benefit managers and retail pharmacies. The Society continues work on harmonizing continuity of care records standards ("One hopes this standard makes it," says Magee.); offering on-site consulting services to members through the Physician Practice Resource Center; and supporting Medem's HIPAA and ERisk-compliant customizable practice websites.
"It all boils down to trying to assist [physicians] with implementation," says Magee, who deployed an EMR system at his own office four years ago and is now working to develop a portal that patients could use to access parts of their records. "We're trying to raise people's consciousness."
Of MMS' 18,500 members, Magee estimates less than 25 percent have partial or total EMR systems up and running. The most recent MMS statewide survey (2003) showed that while nearly three-fourths of all physicians believe computers are becoming a necessity, most doctors have been quicker to use technology in administrative applications rather than clinical applications.
"Cost is an issue," says Dr. Eugenia Marcus, chair of the MMS Committee on Information Technology. "The whole managed care scene has squeezed physicians so much that they don't have the resources to invest in infrastructure they need to make this step. Small practices are hanging on by their fingertips in terms of economics. My thought is that EMR through an [Internet service provider ]will be the most affordable way to go, and it's going to take some time."
Indeed, a report released this summer by the Boston University School of Public Health asserted the average gross income of Massachusetts physicians is only 70.5 percent of the national average. Factor in rising expenses, decreasing reimbursements from public and private payers, and hefty administrative requirements, and there is little incentive to "put money into a system that may become obsolete or you constantly need to upgrade and learn," says Ted Blizzard, vice president of information technology at MMS.
Magee remains optimistic. EHR systems will be commonplace in 10 years, he says, pointing to steady adoption in the Worcester-area community in which he works. "I see that happening by the month; more and more offices moving toward this. When you're dealing with thousands and thousands of individuals in a particular industry, there will always be some who will not want to change, but maybe when the use of electronic medical information is required, then of course, that will accelerate things in a broad implementation."
Magee says Massachusetts' culture of innovation and its clustering of academic and medical institutions primes the state to be a leader in implementing health-IT. "We are beyond the innovator and early adopter stage and moving into a stage of advancement," says Magee. "And that will only accelerate."