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More Ohio Doctors Use Electronic Records,

A physician's advocacy group estimates about 25 percent of Ohio doctors have converted their medical records from paper to electronic. More practices are expected to make the change as financial incentives from the new federal health care law are made available. But, some early adopters of e-records tell a cautionary tale. WOSU's Tom Borgerding reports.

Ohio doctors and hospitals are in the midst of a huge conversion of millions of patient medical records. The paper records are being scanned into computers and stored for easier retrieval and transfer. Akron Doctor Brian Bachelder was among early adopters of electronic medical records almost a decade ago.

"People are impressed by it. I think it helps them to feel that their information is being kept in a very solid format rather than shoveling through papers where you can't find anything."

Bachelder says e-records make it easy to view a patient's past medical history, their information, and their medication list. "Everything that helped me to take better care of them."

But, Bachelder says those benefits come at a cost. A decade ago he paid about $12,000 to scan his paper records and set up a storage and retrieval system. "The thing is that same system today has gone from about $12,000 to almost $50,000. So, that huge expense makes it a barrier for the small physician, the one to five physician office, to be able to get into the game."

To accelerate adoption of medical e-records the federal government offers incentives to doctors and hospitals. Physicians can receive up to $63,000. Hospital systems can get up to $2,000,000 to convert to electronic records. Karen Preston of Fireproof Records Center in Grove City says conversion to electronic medical records has lead to more consolidation in the medical industry.

"But what I have found out is that a lot of doctor's offices are selling out to larger hospitals and things of that nature, because its a major expense for them. Its a major conversion for them to convert records, to bring in equipment, to have the knowledge and things of that nature." Says Preston.

The Ohio State Medical Association advocates for Ohio doctors, residents and med students. It has 20,000 members. Spokesman Jason Koma says while the actual number of consolidations and mergers among doctors and hospitals is unavailable, the trend is driven in part by the high cost of conversion to electronic medical records.

"This giant shift toward a more connected, a more health information technology-driven practice of medicine is one of the factors that is helping contribute to what is a significant increase in physicians either affiliating or going into direct employment with health systems."

But, as more doctors adopt e-records, some are taking note of more subtle changes in their practices.

"Well the experience right now is not too good yet."

Doctor Gale Hazen is a surgeon in Lorain County. He says while electronic medical records provide more access and portability, financial savings are more difficult to achieve.

"EMR's are starting to decrease our efficiency. And I am talking about practices that have already been using EMR's in a mature way of five years or more. Studies have shown that their efficiency is actually decreasing rather than increasing. I know that sounds odd but it is true."

Since he began using medical e-records, Hazen says he often has to go through three or four computer pages to get the correct prescription for a recovering patient. Take Tylenol for example.

"Well there's lots of different ways to take Tylenol. There's tablet, there's elixir, there's pediatric dosages and so forth. Right now, I write Tylenol, number of milligrams, and the patient gets it. Under physician-order-entry in the computer I have to have every single Tylenol variation so that I can check the box for the one that I want rather than just being able to write out the variability, which means that I'll have right at this time we have 600 variations of Tylenol"

Hazen says thats not efficient. He adds that multiple choice format or the ability to automate alot of medical documentation has created unexpected problems.

Tom Borgerding WOSU News