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Medicare Lacks Health IT



By Stacy Lawrence


Of the 40 million elderly patients covered by Medicare, most visit doctors who use very little information technology.

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A report recently released by the HSC (Center for Studying Health System Change), a nonpartisan policy research organization, revealed that a majority of Medicare fee-for-service outpatient visits were to physicians without significant information technology support for patient care.

The study linked Medicare claims data to the nationally representative physician survey conducted by HSC. Researchers found that 57 percent of Medicare outpatient visits were to physicians in practices that used IT for no more than one of the following five clinical functions: obtaining treatment guidelines, exchanging clinical data with other physicians, accessing patient notes, generating preventive treatment reminders for the physician's use and writing prescriptions.

Access rates across individual clinical IT functions varied considerably. While half of Medicare outpatient visits were to physicians in practices using IT to obtain treatment guidelines, the proportion of visits to physicians in practices with IT support for other patient care functions was much lower, falling to 9 percent for electronic prescribing.

Physician IT usage varied little according to the relative health, or lack thereof, of patients or by the race of patients.

In fact, study authors noted that Medicare beneficiaries' limited access to physicians with clinical IT simply mirrors the general population, since it reflects physicians' slow rate of IT adoption.

More than three-fourths of Medicare outpatient visits were to physicians in practices with fewer than 50 physicians, the practices that are least likely to adopt clinical IT.

Based on a sample that included claims for more than 506,000 Medicare outpatient visits to 8,641 physicians, the study's findings were weighted to be nationally representative of all Medicare fee-for-service physician outpatient visits in 2001.

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