Morning Read: Physicians expect IT use to skyrocket in next two years

Highlights of the important and the interesting from the world of health care:

The government can’t do anything right? Last year’s federal stimulus seems to be pushing up health IT adoption among small-practice doctors, exactly as backers intended. A recent poll of 1,000 doctors shows that currently just 15 percent use electronicmedical records, yet 58 percent say they will within two years, according to Accenture and Harris Interactive. That’s pretty dramatic growth, and what you’d hope for given that the stimulus contained $19 billion for health IT. (Each individual private-practice doctor could get up to $44,000 to help pay for EMRs.) A key point about the poll is that all of the 1,000 physicians surveyed worked in practices of 10 docs or fewer–that is to say, practices far less likely than huge health systems to be able to afford costly EMR systems. So that speaks even further to the success of the stimulus. Now, you can certainly argue that many of these docs would’ve bought EMRs anyway, but one can’t deny it’s a much easier purchase to make when someone slips $44,000 into your pocket. (Federal penalties that are scheduled to take effect in 2015 and reduce Medicare payments to physicians who don’t use EMRs certainly didn’t hurt the cause, either.)

It remains to be seen whether today’s EMRs are capable of helping to improve care and cut health costs, but the HIT industry will get there someday. This is a good start.

The end of pre-emption? A seemingly nonsensical Supreme Court decision from 2008 that effectively shielded medical device makers from most lawsuits could soon be a thing of the past, MinnPost reports. In the wake of 13 deaths linked to a Medtronic device, the Supreme Court ruled that families of the deceased couldn’t sue the company because the FDA had approved the device in question. The decision was founded on a doctrine known as pre-emption, as in the FDA’s approval of the device pre-empts citizens’ rights to sue the manufacturer. If that seems like an egregious subjugation of the American people’s rights to the interests of corporations, welcome John Roberts’ America.

MinnPost insightfully compares the pre-emption decision to Minneapolis’35W bridge-collapse tragedy: If families can sue companies that created a dangerous and faulty bridge, whydoesn’t the same concept apply to device makers? Recently, though an Illinois court made a ruling that weakened pre-emption, in a decision that denied the defense to a drugmaker seeking a shield from suits alleging drug-induced suicide. And if a piece of legislation percolating in Washington ever finds its way to a vote, pre-emption could be relegated to the dustbin of history, where it belongs. America’s health care consumers would be better off for it.

Why fee-for-service medicine has got to go: Writing a guest post at KevinMD, Pearl Korn describes her perplexing, frustrating and costly experiences in dealing with fee-for-service medicine, in which doctors are paid based on procedures they perform, not on the health outcomes those procedures bring. Korn injured her leg falling down the stairs, a mishap that led to visits with an emergency room doctor, three orthopedists, a physiatrist and three neurologists. Through it all she’s endured several misdiagnoses and unnecessary procedures. One doctor even recommended two back surgeries, though she has no pain in her back.

The experience has left Korn convinced that fee-for-service is warping incentives and creating exorbitant and unnecessary costs to patients. “Fee-for-service has reduced doctors to assembly line pieceworkers, paid by the office visit and procedure rather than by effectiveness of treatment,” she writes. “The result is an inefficient, costly and dangerous system.”