April 8, 2013

Rural doctors unprepared for future, need resources

By Magen McCrarey
Staff Writer

LAUREL COUNTY, Ky. — Within the next two years, many health care providers will go to paperless records, and rural southern Kentucky doctors are unprepared.  The newest Electronic Health Records (EHR) survey released this week revealed that 63 percent of rural health providers have not installed new EHR software as mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act, and 73 percent of doctors said they need outside help.

Richard Murch, IT consultant and EHR specialist authored the survey, which was distributed in January and February of this year.  The survey of 431 rural doctors was commissioned by Stronger Economies Together (SET), a USDA Rural Development program to help southern Kentucky enhance the biomedical and life science field.  

This region is only one of 20 areas in the country to receive this assistance.

According to the survey’s findings, more than 280 small and rural medical practitioners in Kentucky could face financial penalties from Medicare and Medicaid if they do not comply and do not have the new software installed by 2015.  Six medical practices stated they will never install the EHR technology, and out of those six, three said they will close.

“We’ve already identified people that are closing their practices.  We are going to have a shortage of doctors in this region,” Murch said.

Stephen Taylor, development director of the Kentucky Highlands Investment Corporation (KHIC), said Kentucky lags behind the nation in the number of physicians per 100,000 people.  

“We have a disconnect and we are in real trouble,” Taylor said.

Thomas Fern, state director of USDA Rural Development, believes the impact will not be as bad as predicted.

“Implementing new programs and practices at first seems overburdensome, until they see the process and how it’s working and, as a result, sometimes many come to the table say, ‘this is not as near as bad as I thought it was going to be.’”

The HITECH Act was created to stimulate the adoption of electronic health records.  Health-care providers are being offered financial incentives for EHR implementation until 2015, after which time penalties may be assessed for failing to use the program.  

Education gaps

Forty-two out of 110 medical practices/hospitals who returned the survey said they are experiencing difficulties finding qualified and experienced EHR IT staff.  Six hospitals indicated they need to teach their patients how to use EHR to access their own health records.

“Many patients will welcome the fact that they can really see their diagnostics and tests,” Fern said.

When patients are able to look at their own medical data, they will be able to receive better information about their health, which means better quality, Murch said.  Patients then will be able to report symptoms earlier and have a better chance of effective preventative health.

Murch said 73 percent of doctor’s practices have asked for aid, so SET is creating a fast-track plan to provide education and training.  

“They can’t find the staff, they can’t recruit them…These are jobs lost.  If we train people in EHR, they can fill those jobs. The need is there,” Murch said.

Lois McWhorter, associate dean at Somerset Community College’s (SCC) said currently there is no extensive EHR/Health Information Technology (HIT) course or degree offered at Kentucky universities, posing a problem for the demand that is expected to increase within the next two years.  

Eastern Kentucky University’s Health Care Administration and Informatics (HCAI) course was close, but had gaps in curriculum.  Northern Kentucky University only offers a short online course, but no degree courses. Western Kentucky University offers an associate and bachelor’s degree in Health Information Science but it needs substantial enhancement.

The IT of today is not the IT of the past, Murch said, and students now need to learn multiple hirable skills in addition to writing code and database administration, such as business management and HIT knowledge.

“In today’s industry, you have to have those skills. We have to do more. IT is not just about writing code these days,” Murch said.

SET’s plan is to provide education and training for medical staff who will be or are using technology.  Coordinators hope to provide new courses at community colleges and universities for people who want to enter or are already in the EHR field and offer online training for patients of the hospitals, clinics and doctors on how to access their medical records.  

We must begin training for jobs that don’t exist right now — but they will exist, Murch said.