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Kai Ryssdal: The story of the health-care debate is going to seesaw back and forth over the next couple of weeks. Between a discussion on the economic merits and political calculus. President Obama did a little bit of both today. He met with staff at the National Children's Medical Center this afternoon, after which he stepped to the microphones.
PRESIDENT OBAMA: Now there are some in this town who are content to perpetuate the status quo. Who are fighting reform on behalf of powerful special interests.
That's the political part. But he talked economics, too.
PRESIDENT OBAMA: We all know there are more efficient ways of doing it. I spoke to the chief information officer here at the hospital, and he talked about some wonderful ways in which we could potentially gather up electronic medical records and information for every child not just that comes to this hospital, but the entire region. And how much money could be save and how the health of these kids could be improved.
Digital medical records could cut down on office visits. They would let people transfer their records easily. But for doctors, going electronic could be complicated and expensive. And nothing at all like what they learned in medical school. Marketplace's Caitlan Carroll reports.
CAITLAN CARROLL: Thomas Mohr runs Pediatric Partners, a large medical group in Southern California.
THOMAS MOHR: How'd he sleep last night?
He's just finishing up with a young patient.
MOHR: He slept OK. Just on and off.
Mohr's days are full of pint-sized patients suffering from ear infections, runny noses and chicken pox. Lately, he's also started seeing a lot of adults. But they're not here for his medical expertise. They're here to check out his electronic medical records.
MOHR: We had a large group come through from Texas a few weeks ago, and they really want to go with this system. So they brought their physicians who were sort of the naysayers. And by the end they were pretty convinced that this was the way to go.
Mohr's a pioneer when it comes to electronic medical records. His clinic first digitized its files in 2003. It was a disaster.
MOHR: Everytime we upgraded the system with more software, it would lock, and we would lose data, and people would be frustrated. So we scrapped it.
A couple years later, Mohr took a deep breath and tried again. This time it worked. But he hasn't forgotten how hard it was the first time. All the questions and concerns. Very few answers.
MOHR: Physicians are scared. They're busy. So they're scared that it's gonna slow them down.
That's not the only fear. Jonah Frohlich is with the nonprofit California Healthcare Foundation. [See editor's note below.]
JONAH FROHLICH: This is a big investment for them. It's $25,000 minimum per doctor, and it's probably more like $40.
And the industry is so new, there are few standards. Doctors don't know which systems are best and which companies are likely to be around for the long haul.
FROHLICH: It leaves an underlying question here, which is: How do practices make that decision in the first place? Because many of them really don't have very good guidance.
So far, only about a quarter of doctors and hospitals have gone electronic. And with the addition of government incentives, what has been a slow-growing market, could explode into a billion dollar business.
Lindy Benton is the Chief Operating Officer of Sage Healthcare, a medium-sized medical records company. She deals mostly with small practices and clinics. Her reps are busy trying to sign doctors up. But it's a delicate job -- holding their hands, while pushing them along.
LINDY BENTON: The questions that we get most often asked are how much will it cost? How would I set my practice up? Will it change the way I practice?
DR. BOBBY KATZ: I can click and see what they need. This lady needs a refill on sleeping aids. Since I know that they're all here...
That's Dr. Bobby Katz. He runs a busy obstetrics practice in Beverly Hills. Katz chose Sage to take his practice digital. He says computerizing his records has paid off in better medicine. The decision was still daunting, though.
KATZ: You're talking to a doctor who doesn't know anything about this stuff. Fortunately, we have an excellent office manager who did a lot of screening for us.
A small office could spend over a $100,000 in the first five years for hardware, software and IT support. And its critical to get everything you need built into the system from the start.
Sandra Krutell is the manager for Katz's practice.
SANDRA KRUTELL: It can become extremely expensive if there are a lot of add on costs and that, of course, is a pit fall whenever you're dealing with something you're not familiar with; it's not like going and buying furniture.
The systems are complicated. They need to be customized to individual practices. And every new application comes with its own price tag. Kind of like health-care.
In Los Angeles, I'm Caitlan Carroll for Marketplace.
[* EDITOR'S NOTE: After being interviewed for this story, Jonah Frohlich has become the deputy secretary for health information technology for the California Health and Human Services Agency (CHHS).]