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

222 M.M. Simonian
organizational barriers to overcome, with added complexities including corporate
taxation and labor issues. In contrast, small practices, with fewer resources, have
greater flexibility and agility in making the necessary decisions for IT adoption.
Small practices must, out of survival, adhere to the maxim of “No margin, no
mission.” In addition to debts from medical education (many physicians are repaying
educational debts of over $200,000, 5 small practices must remain competitive
( continuing education, new equipment), which increases burdens on practice owners. In
smaller practices, practitioners must also stay current on effective coding and billing for
rendered services to be productive and to maintain sufficient operational income.
In this context, IT can be an investment, but small practices must be much
more cautious than larger ones due to smaller financial resources. To facilitate
acquisitions, small practices may form purchasing groups with other practices or
local medical associations. Even so, the benefits of IT purchases in reducing labor
costs through increased efficiency are difficult to measure directly.
16.2.2 Quality Data Reporting
Increasing requirements for clinical data collection and reporting for quality
assurance, continuous professional development and regulatory auditing place
additional burdens on practices. Newer reporting requirements go beyond what is
traditionally contained in claims data and into data that is available only in clinical
records. Thus, IT systems provide an attractive possibility to reduce the burdens
and costs (lost practice time and additional staff to collecting data).
16.2.3 Time Management
The combination of these pressures leads to higher demands for productivity: more
patients seen per day, more time spent at the office, less time for family and other
activities. IT tools can support efficient management of financial, documentation,
and reporting functions to make time for other activities, including continuous professional
development, advocacy, networking, and family.
16.3 Weighing Benefits and Costs
16.3.1 Benefits
In selecting IT for a practice, primary drivers (beyond cost) to adopt are ease of
use and perception of usefulness of a technology. 6 Tasks for which IT may provide
benefits include:
Optimizing charge capture, coding, and billing
Assuring complete documentation of encounters, procedures, and time