Digital medical records can improve coordination of care, but the high cost and reduced productivity involved in implementing them are hurting some health care providers.

Patient care now includes far more computer time for physicians such as Dr. Frances Meredith.

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“The requirements of what is included in a patient chart just to submit a bill got very long, got very time-consuming,” said Meredith, a primary care physician in Cary.

She said she sees value in electronic medical records, “but it’s become clear the cost associated for a small practice is becoming a weight that is too heavy to bear.”

Hospitals and large medical groups have spent $2 billion statewide on technology to track medication and better coordinate care, but an estimated $40,000 to $100,000 for software can be crushing for a small practice.

Without an upgrade, however, medical practices will see their federal reimbursements cut under the Affordable Care Act.

Meredith said the changeover could put her out of business.

“I think it’s building to a crisis point,” said Dr. Greg Griggs, executive vice president of the North Carolina Academy of Family Physicians.

Griggs argues that reform is needed to better compensate front-line doctors to cut catastrophic costs later.

“None of us would drive our car and never change our oil until we had engine failure,” he said. “That’s how we treat health care. We’re not investing in the upfront maintenance.”

Meredith said she doesn’t blame anyone because the shift to electronic records started years ago. Still, she must deal with the bureaucratic consequences, so she and the partners in her practice are considering options such as joining a large medical group or shifting to a cash-based system, much like a 1950s health care model.

“It’s taking away what I love about medicine, and it’s taking away the essence of what medicine is,” she said.