Why is it that societies' smartest people-those who pioneer the use of cutting-edge technology to advance the practice of medicine-are often last to embrace business technology that would make their practices far more efficient?

We are speaking, of course, about physicians, and the health care organizations they build. Physicians won't hesitate to implement the latest proven diagnostic and treatment tools, such as 3D imaging, robotic surgery or nanotherapy. The patient benefits are clear and justify the investment.

But when it comes to their practice management, physicians are, by and large, technology-challenged. Most still take notes with pens and clipboards, double-enter patient information on computers installed years or even decades ago, collaborate via inter-office faxes, and so on.

Look no further than Congress for evidence that practice management is stuck in an '80s mindset. For years, legislators have been drumming up proposals devised to motivate health care organizations to embrace EHRs.

Indeed, multiple bills are winding their way through Congress right now, including HR 2377, reintroduced by Rep. Phil Gingrey (R-GA), which uses tax abatements to encourage health care organizations to invest in HIT, specifically EHRs and e-prescriptions.

What's wrong with this picture? Congress is throwing money at physicians to adopt a process-digital record keeping-that businesses in general have been using for more than 20 years. And that's only the beginning.

Health care's reluctance to modernize practice management and reimbursement systems has reached epidemic proportions. The primary symptom: spiraling health care costs put intensive downward pressure on physicians' revenue while, at the same time, put upward pressure on their costs. The result: another "catch 22" in the health care crisis.

The time has come for physicians to become advocates of IT solutions and services as modern and innovative as their diagnostic, treatment and surgical tools. By reducing costs, improving workflow and streamlining operations, modern management systems and services can help cure what ails the health care field, and resuscitate a struggling industry.

Cost Catalysts and Containment

A recent RAND study determined that HIT, when properly implemented and widely adopted, would save money and significantly improve health care quality-the two biggest issues facing the health care industry.

EHRs are only one piece of this much larger puzzle. One often overlooked reason costs are climbing: the lack of comprehensive practice management software. Practice management covers all aspects of workflow, including patient and room scheduling, billing, prescriptions, transcription and EHRs.

One assumption that is popular, including in Congress, is that any IT investments will save money and improve care. EHRs have proven to be a classic example where this assumption is wrong.

It can cost nearly half a million dollars to install an EHR system, plus $10,553 a year in staff costs (per full-time physician) to operate, according to the Medical Group Management Association (MGMA). And that doesn't factor in the ongoing technical staffing and IT costs these more complicated systems require. Larger organizations can absorb these expenses, but smaller ones can be crushed by them.

Compare that to the $10,009 in staff costs when managing paper records within a practice. The bottom line: EHRs may improve care but only at a financial cost. No wonder that only 10 to 20 percent of physician's have installed EHRs.