The Sunday's edition of The New York Times (10/3/2010) has a story on the journey of Doerr Brother's healthcare software company. The story exemplifies the challenges facing many technology companies that service the American healthcare industry.
John and Tom Doerr started ClearPractice in 1999, a software company that made electronic health record products for small physician practices. The brothers thought that the obvious benefits of EHRs would make their software an easy sell. However, 10 years into the business, they had fewer than 500 doctors using the product. Since 2000, many large health systems have adopted EHRs but adoption among small physician practices is still lagging.
Small physician practices provide more than 85% of the healthcare services offered in the U.S. Almost all physicians operate on a fee-for-service model, which means the incentive is to do more of everything - tests, prescriptions, surgeries, etc. - but no incentive to adopt EHRs. The federal stimulus package will reduce the cost for adopting EHRs through subsidies; however, a fundamental shift in healthcare economics is needed in order to drive the adoption of EHRs among small physician practices.
Hospitals have historically viewed infection prevention as a heavy expense. The same rationale that prevents small physician practices from adopting EHRs, i.e. high investment cost and lack of quantifiable benefits, also prevents hospitals from adopting best practices and new technologies for infection prevention. Mandatory reporting and pay-for-performance are pressuring hospitals to scrutinize their infection rates more closely, which will hopefully drive up adoption of new technologies and best practices
Times' article on Doerr Brothers