Pediatric Informatics: Computer Applications in Child Health (Health ...

Chapter 16
Prioritizing Pediatric Investment
for IT in Smaller Practices
Mark M. Simonian
Objectives
To discuss IT investment for small practices from a pragmatic viewpoint
To list the steps and issues of adoption
To provide a description of a solo practice adopter
16.1 Introduction
Small practices are the least likely to adopt electronic health records. 1–4 Practical
business decisions determine the choices that office-based physicians make in
prioritizing information technologies purchases. Beyond basic clinical and clerical
tools (stethoscope, typewriter, telephone, or fax), practices need to consider customer
and market expectations, business efficiency, and regulatory issues to choose
IT applications that impact on the quality of practice services and the bottom line.
16.2 Pressures in Small Pediatric Practices
16.2.1 Financial
Regardless of size and mission, pediatric practices are businesses, and as such, must
build a loyal clientele with a steady stream of sustainable business. Practices have
investments in licensing (for clinicians, offices, and point-of-care laboratories), labor
(salaries and benefits for nursing and support staff) and equipment (overhead costs
for rental, utilities, and supplies). They earn revenue by providing clinical services to
patient groups and individuals (contracts and fee-for-service) and may provide pro-bono
services. Practices also compete with other practices for patients in an era when reimbursement
levels have decreased and documentation requirements have increased.
Some of these financial pressures may be mitigated by the size of an organization.
Larger practices may have more resources to invest, but also have greater
C.U. Lehmann et al. (eds.), Pediatric Informatics: Computer Applications 221
in Child Health, Health Informatics,
© Springer Science + Business Media, LLC 2009