Health Information technology (HIT) is a valuable tool for practices of all sizes including small practices. If you ask any provider who has successfully implemented an EHR system, most would say that they would never go back to using paper records. The tool helps providers to meet criteria associated with meaningful use, patient centered health homes, and membership in Accountable Care Organizations (ACOs). HIT also helps hospitals to build systems which allow for interoperability and improved technical efficiencies as they extend services to their provider base. Let’s not forget the many added patient centered options that allow medical systems to improve the patient experience. The technology is continuing to morph into a more supportive network for medical practices.
While the technology is a blessing on one hand, there remain many barriers that are preventing smaller practices and small hospitals from having successful business operations. Gone are the days where a solo practitioner can only practice good clinical medicine without having good business practices and still be able to sustain a successful operation. To maintain a good business practice takes more than a good business mind, it takes multiple resources. There are a number of factors that are disabling the smaller medical organizations. They include: the high cost for technology and staffing; rising overhead cost; increasing payer oversight and requirements; low reimbursement for services including the looming sustainable growth rate; decline in office visits. Solo medical practices are closing down and these providers are joining larger health systems in an attempt to remain in the game.
The recent Health reform encourages consolidation of services to build larger more effective systems. This often leaves out the smaller practices and hospitals. The expansion of Medicaid can help steer more Americans into primary care practices in an attempt to ease the burden on hospital emergency departments but the law does not account for coverage of millions of undocumented immigrants that may frequent the emergency rooms of rural and critical access hospitals.
How can we help the small practices and hospitals? Maybe we can start the discussion at all levels including looking at policies that will allow for growth of the health system while also supporting the sustainability of smaller medical operations. The health system is being played on a much larger game field which puts the smaller players at a disadvantage. We may have to hold back some of our excitement about innovative technology for larger health systems and think about the rural and underserved areas that really need those local hospitals and providers who are about to close their doors. Before any system change, there must be a conversation. Let’s enter the subject of “the needs of small medical practices and hospitals” in every strategic conversation concerning HIT and the greater health of this nation.