Electronics may decrease in-person physician visits

BALTIMORE — Will the growing use of health information technology (IT) and electronic-health (e-health) applications impact the future demand for physicians?

Researchers at the Johns Hopkins Bloomberg School of Public Health and The Commonwealth Fund think so.

Based on their analysis of recent trends in digital health care and a review of the scientific literature, the authors conclude that patients’ future use of physician services will change dramatically as electronic health records and consumer e-health “apps” proliferate.

“The results of our study are important because they provide a forward looking snapshot of how health IT will profoundly impact the American health care workforce over the next decade or two,” said the study’s lead author, Jonathan Weiner, professor of Health Policy and Management at the Johns Hopkins Bloomberg School and director of the Center for Population Health Information Technology.

Changes

Today, in large part due to federal “meaningful use” subsidies, more than 70 percent of office-based physicians are making use of electronic health records. Only a decade ago, the figure was about 10 percent.

Also, consumers are increasingly using the Internet and mobile phones to manage their health.

In the not-too-distant future, it is likely the majority of patients’ interactions with the health care system will be digitally mediated. The impact of health IT on the care delivery environment will be far-reaching.

Increased efficiency

Weiner and colleagues estimate that when electronic health records and other e-health systems are fully implemented in just 30 percent of community-based physicians’ offices, U.S. doctors will be able to meet the demands of about 4-9 percent more patients than they can today, due to increased efficiency.

When supported by health IT, delegation of care to nurse practitioners and physician assistants could reduce the future U.S. demand for physicians by an additional 4-7 percent.

Along the same lines, IT, such as “e-referral” systems, could help reduce the national demand for specialists by another 2-5 percent as specialist physicians are able to delegate care to generalists.

Benefits

RemoteHealth-IT, such as telemedicine and secure patient/doctor digital communication, could help address regional doctor shortages by enabling 12 percent of care to be delivered remotely by doctors living in other locations. The forecasts could be much higher, if doctors and patients adopted comprehensive e-health and IT more widely.

“When all of these likely effects are added together, it is clear that health IT will help resolve future physician shortages that many believe are around the corner,” Weiner said.

Although there is considerable room for further empirical research on health IT’s impact on health care workforce market dynamics, the authors conclude that few trends will change the future face of American health care as widely as health IT and e-health.