Summit Fully Electronic Medical Record Compliant​

For more than 40 years, paper records have worked just fine for Dr. Bob Proffitt and his patients.

Proffitt, a primary-care doctor in Maryville, has never seen a need to switch to electronic patient records, and he worries about their security, mentioning “social things relevant in the care of patient,” for example, that he wants to discuss but doesn’t necessarily want on a patient’s “record” for others to see.

“Another reason, it’s very easy for information to be lost, just to be wiped out,” he said. “I’m a little leery of that.”

Then there are the logistics. In a practice with longevity like Proffitt’s, “how current would you keep charts?” he asked. Do doctors go by the standard legal requirement — seven years — or longer? Proffitt has had literally thousands of patients over the ​years; even transferring the 400 or so “current” paper patient charts would be a big job, he said.

Proffitt isn’t alone in his qualms. Though the majority of doctors have adopted electronic patient records, especially in recent years, a study last year found a third of U.S. physicians still don’t use them. But next year, the law will seek to change that.

The Patient Protection and Affordable Care Act includes a mandate for standardized electronic patient records, set to take effect in 2014. The government hopes to soften the blow by offering practitioners financial help. Over the next decade, those who meet federal requirements can get up to $44,000 through an “incentive program” to implement electronic health records systems — even more if they’re serving patients in a Health Professional Shortage Area, which many parts of Tennessee are. Hospitals, too, can qualify for funding help — $2 million and up — but have more stringent requirements.

Still, even with the extra funding, the switch is a lot for practitioners to take on, especially those who practice solo, with a small office staff, as Proffitt does.

Doctors must invest not only the money for the new system, which some have estimated at $40,000-$80,000, but also the time and training of staffers.

Some may have to hire extra office help, increasing practice costs. Some may partner with larger organizations. Some may simply retire rather than deal with it, though Proffitt said he has no plans to do that.

Tim Young, CEO of Summit Medical Group, said the new requirements may be among the reasons the multi-physician primary-care grou​p has seen “an uptick in smaller practices wanting to join our group.”

Founded in 1995 by 37 physicians, the organization now includes around 220 primary-care doctors serving 11 counties. It began using electronic prescription software more than a decade ago. Summit Medical is fine-tuning electronic patient records now. Last year, three independent practices were added, and Young expects “incremental” growth to continue as more physicians join larger groups to help absorb the administrative costs brought on by the new requirements.

Doctors who do not adopt the government’s electronic record system face penalties beginning next year. Some, such as Dr. Tom Kim, who runs South Knoxville’s Free Medical Clinic of America, say they have little to fear.

Because Kim does not charge his clinic patients (or seek insurance reimbursement), he’s not sure how he could be penalized if he does not institute the computer system. But he’s certain he would be penalized if he did.

His office staff consists primarily of older, retired volunteers, he said, “and they told me they would quit” if he went to computerized patient records.