High costs remain as high barriers that are currently keeping small physician groups from making the switch to electronic record-keeping documents. According to a recent study published in the New England Journal of Medicine (NEJM), a conversion from what some would say is an antiquated printed records system to an electronic system on average costs about $40,000 per physician.

The cost is comprised of buying new software and obtaining technical support to make the shift. Then the doctor's staff must go through the arduous task of converting the paper records to computer records — thus reducing the practice's ability to see patients.

But in the spirit of "disruptive technology" — a phrase that gets bandied around quite a bit — Webahn (Lathrup Village, Michigan) has reported the launch of an online electronic medical record (EMR) application called Capzule.Com. This new system makes it affordable for small physician groups to make the switch, according to the company. And instead of a cost of $40,000 per physician, the online cost of Capzule.com would be around $200 per month, per physician.

"The main difference between an installed system and [Capzule] is that you don't have a server that you need to maintain, which cuts down cost tremendously," Vinu Nahir, CEO of Webhan, told Medical Device Daily. "It's just like accessing your G-Mail account."

The web site contains information on the patient, photos, and personal records regarding their condition. Physicians' groups are given a special password to log into the web site.

"We aren't the first to do this; there are other web applications that started replacing the other electronic systems about one or two years ago," he said. "But unlike other web-based competition we combine all the modules they sell separately together. We wanted to offer Capzule as a single solution."

The company has some stiff competition as it bumps heads with Microsoft (Redmond, Washington) and Google (Mountain View, California) which recently have begun services that offer consumer-controlled personal health records over the Web.

Athenahealth (Watertown, Massachusetts) also has a web-based service that focuses on supplying online financial and electronic health record services.

The launch of Capzule.com comes at an ideal time, Webahn said. Originally in a beta stage for about four months, the company decided to speed up the time table and release the web site after NEJM revealed its cost study results.

The study went on to explain that electronic medical records have helped to improve the quality and timeliness of care. Yet, due to high cost, less than one in five of the nation's doctors has started using such records.

More than 2,500 physicians responded to the survey. Among the small number of respondents who had fully functional electronic-records systems, most physicians reported the positive effects of the system on the quality of clinical decisions (82%); communication with other providers (92%); communication with patients (72%); prescription refills (95%); timely access to medical records (97%); and avoidance of medication errors (86%). Furthermore, 82% to 85% reported a positive effect on the delivery of long-term and preventive care.

The NEJM study was funded by the Department of Health and Human Services, along with a grant from the Robert Wood Johnson Foundation (Princeton, New Jersey). It shows that larger practices have long been early adopters of electronic systems and small practices have continued to shy away from adoption of the technology because of the high start-up costs.

"We want small clinics to have access to these positive healthcare practices as much as larger clinics who can afford expensive systems," Nair said. "As a result, we created an innovative online tool that is not only cost effective, but efficient. Capzule.com is a fast-evolving suite of tools that help small practices deliver quality care."

In addition there has been a much more concerted effort to move the country toward EHRs. Last month the Centers for Medicare & Medicaid Services reported a $150 million Medicare project that will offer doctors incentives to move from paper to electronic patient records. The program is intended to help up to 1,200 small practices in 12 cities and states make the conversion (MDD, June 13, 2008).

Individual doctors will be offered up to $58,000 over the five-year span of the project, which is intended to test the impact of incentives on the spread of EHRs. Further programs across the country are planned.

So far interest regarding the web site has been piqued. Within two hours of releasing the press release the company said it had nearly half a dozen calls requesting more information about Capzule.

Webahn is a private company and was formed in 1999. The company launched its first product, OvernightScribe.com, which originated to provide Internet-enabled clinical documentation platform to healthcare providers to manage medical transcriptions.