Doctors and Hospitals Say Goals on Computerized Records Are Unrealistic

In February 2009, as part of legislation to revive the economy, Congress provided tens of billions of dollars to help doctors and hospitals buy equipment to computerize patients' medical records. But the eligibility criteria proposed by the Obama administration are so strict and so ambitious that hardly any doctors or hospitals can meet them, not even the most technologically advanced providers like Kaiser Permanente and Intermountain Healthcare.

Doctors and hospital executives, who have expressed their frustration in meetings with White House and Medicare officials, said the issue offered a cautionary tale of what could happen when good intentions meet the reality of America's fragmented health care system. The goal of the law is to provide financial incentives, through Medicare and Medicaid, to encourage doctors and hospitals to adopt and use electronic health records. When the bill was passed, the Congressional Budget Office estimated that the incentive payments would total $34 billion. It is no surprise that tiny hospitals in the Midwest and doctors practicing by themselves would grumble about the White House proposals. But elite institutions have similar concerns. Among those expressing deep reservations about the proposals are pioneers in the use of health information technology like Kaiser, Intermountain, the Mayo Clinic and Partners HealthCare System in Boston, which includes Brigham and Women's Hospital and Massachusetts General Hospital.