Health Information Compliance Alert

"How soon" depends on effectiveness of federal stimulus, experts say.

The electronic health records (EHRs) "meaningful use"debate continues to make waves as practices grapple with whether or not they qualify for sizable financial incentives.

The federal stimulus bill allots approximately $19 billion in Medicare and Medicaid incentives for physicians, hospitals and other healthcare organizations not only to adopt certified EHRs but also to use them in a meaningful way. Early adopters have been promised bonuses, but these bonuses will turn into penalties for players who do not act fast enough, reports Chris Silva in a post on www.amednews.com.

Around two weeks before the proposed "meaningful use" rules were issued by CMS, Data Health Management conducted an online poll asking participants how soon they thought EHR will be adopted. A total of 83 responded in the poll and opinion was nearly equally divided amongst those who thought adoption of EHRs would be rapid and those who thought it would be gradual, reported Bill Kenealy in a post on www.healthdatamanagement.com.

Kenealy further said this poll shows that while a broad consensus exists about the future viability of EHRs, opinions differ about how and when that future will arrive.

One of the participants in the poll, Karl D. Schubert, managing partner and chief technology officer of Minnetonka, Minn.-based TechNova Consulting, feels that the expansion of EHRs is going to be gradual. In a post-poll interview, he compared the adoption curve to how banks rolled out ATMs -- which was certainly not a lightning fast event. "The future for digital health is bright, but it is not going to happen overnight. It will not be easy,and we will have to invest money to save money and improve health care in the long run."

Schubert said in the interview that technological challenges and roadblocks will need to be resolved before EHRs are widely adopted. "Today's average interaction by a health services consumer still involves a 19th century paperwork trail, and that drives costs up, efficiencies down, and [can cause] improper diagnosis and treatment,"he said. "There are major challenges, though, that will need to be overcome such as universal data taxonomy, ease-of-use for the consumers and providers, personal information safeguards, and checks-and-balances to ensure that the data is good and remains good."

Another factor that divided respondents of the poll between the "Rapid" and "Gradual" factors was the impact of the spending stipulated under the American Recovery and Reinvestment Act (ARRA) of 2009 to encourage meaningful EHR adoption. Twelve percent of the respondents dismissed this stimulus effort as being merely cosmetic.

But Brett Harnett, research assistant professor and chief, division of I.T. at the University of Cincinnati Dept. of Surgery, disagrees with this twelve percent and says that the push which the ARRA provides will definitely catalyze EHR adoption. He compares the federal program with a mandate of sorts. According to him, even though the program does not specifically require EHR, it does eventually penalize practices without this technology by reducing their government reimbursements. "The government has taken a two-pronged approach to the adoption of EHRs," he said in an interview following the poll."First by mandating it and second by incentivizing it. Although there are issues to resolve such as interoperability and unique patient identification numbers, the incentive represents a financial 'carrot' that should be embraced by providers."

Donna DuLong, a consultant at Ridgefield, Conn.-based Apelon Inc., medical terminology management software provider, agrees with this view and said after the poll in an interview that the federal stimulus will speed EHRs along the path toward widespread use. "The federal I.T.stimulus program will not only raise awareness for the need to adopt EHRs, but more importantly, fuel the debate about how EHRs need to improve our ability to deliver higher quality patient care," she says.

Erin Stevenson, a digital healthcare consultant at Redwood Medical Consulting, Bayside, Calif., said in the same interview that EHRs' ability to improve outcomes for doctors and patients will spur adoption of EHRs. In the participants' interview after the poll, he said, "there are still bumps in the road, but inevitably patients win from better and more timely and targeted treatment, potentially earlier intervention and treatment of life-altering health conditions. Doctors can improve their quality of service and bottom line, decrease mistakes, expand their patient base and have access to advanced decision support resources."

(Editor's note: Bill Kenealy's complete post along with the poll-participants views can be read at: www.healthdatamanagement.com/issues/18_3/a-brightfuture-for-ehrs-but-when-39830-1.html. Read Chris

Silva's post on amednews.com at: www.amaassn.org/amednews/2009/06/29/gvsb0629.htm.)