EHR: 6 More Things to Consider

HITECH Act and Meaningful Use: Reasons to Implement and EHR

I just got an email from Jonathan Krasner from BEI Healthcare with an interesting article he wrote about things to consider in your Electronic Health Records (EHR) selection that I would like to share.

Here is the text of Jonathan’s post:
While HITECH and Meaningful Use have given practice managers and physicians good reason to look at implementing EHRs, many other trends and themes related to EHRs are beginning to crop up that could also influence decisions to implement, install and use an EHR. Let’s take a look at a few of these:

1. ACOs and PCMH

ACOs (Accountable Care Organizations) and PCMH (Patient-Centered Medical Home) are the hot new acronyms of healthcare reform. The central idea with both is to coordinate care across settings and providers. How can that really happen if there is no efficient and timely mechanism to document encounters? The short answer: it can’t. Not only are EHRs necessary to document encounters and coordinate care, but they are also necessary to produce data showing clinical outcomes. PCMH will not only be pushed by CMS (Centers for Medicare & Medicaid Services); you can bet that payers will be coming out with their own PCMH programs. In order to participate, physicians will have to use an EHR.

2. Payers

In many instances, policies adopted by CMS are replicated in some shape or form by the commercial payer market (see PCMH above). A recent article in Health Affairs stated, “based on personal communications with the firms’ chief medical officers, several payers, notably, Highmark Blue Cross Blue Shield, Well-Point, Aetna, and United HealthCare—have announced programs to better align existing incentive programs with the definition of Meaningful Use.

Several smaller payers have expressed interest in developing these types of programs as well. America’s Health Insurance Plans, the health insurance industry group, has voiced strong support for the concept of Meaningful Use and potential alignment around it.”

While payers have had EHR incentives in the past, without CMS support these incentives failed to gain critical mass. Another reason why these programs did not receive widespread acceptance was the lack of standardization of EHRs. Both of these issues have changed due to the enactment of HITECH and the Meaningful Use criteria.

As an example, on August 4, 2010, United Healthcare announced it “is deploying its performance-based contracting program nationally, which provides outcomes-based financial incentives to physicians who have successfully adopted EHR systems that meet Meaningful Use criteria” and its “Premium Designation physician performance assessment criteria will include new credit for physicians who use EHRs that meet Meaningful Use standards”.

3. Medical Students

Medical students today are being trained on EHRs in medical school. Going to a practice that runs on paper will seem like going backwards to these new providers. These people grew up online and with smartphones. They are very comfortable and actually prefer these devices.

From a recent EON article: “Students have high expectations for EHRs – Having an electronic health record is a very important factor for 70 percent of medical students in deciding where they will practice medicine. In contrast to industry predictions, students believe the benefits to medical practices will be the main driver for EHR implementation, rather than government initiatives. This is largely due to early exposure to EHR systems, as more than half of respondents said they are satisfied with the level of training their program provided on EHR use.” Whether or not you have an EHR could be the deciding factor for a younger physician considering employment in your practice.

4. Health Systems

IDNs (Integrated Delivery Networks) are increasingly touting their use of EHRs in advertising to consumers on radio and TV. Recent ads by Kaiser in the DC area not only tout EHRs as being able to deliver more efficient communication with providers but also as delivering better outcomes and better health. As an example of this type of advertising take a look at: http://thrivewithkp.org/about-thrive/better-connections-lead-to-better-health. Other IDNs and outside entities such as IBM are also airing similar advertising. Expect these ads to become more frequent as IDNs implement EHRs. They will tout having an EHR as a competitive advantage to lure patients to their networks.

5. State Medical Boards

The ABMS (American Board of Medical Specialties) and the Federation of State Medical Boards have announced their intention to make health IT deployment a standard in their assessment and certification of physician competency. They announced an initiative “to promote the meaningful use of health information technology (HIT) and incorporate them into [its] Maintenance of Certification program”. The board certifies more than 750,000 physicians in the United States.

Meanwhile, the Federation of State Medical Boards President and CEO, Humayun Chaudhry, anticipates physicians’ using “electronic health records as a tool to assess ongoing clinical competence for medical licensure.” According to John Pulley, a writer who focuses on government IT, the boards’ endorsements provide another impetus for doctors to adopt electronic medical records. Until now, the question of adoption has revolved around federal financial incentives. Linking adoption to licensure moves the debate’s focus from cost to competence.

6. Consumers

Ultimately, the push to EHRs will be consumer-driven. All practices can expect more and more patients asking for electronic copies of their records, and pushing copies of their records to physicians via PHRs. The above-noted advertising campaigns and adoption of EHRs by more and more providers will drive awareness of EHRs way up.

For instance, CMS has launched a “Blue Button” service that allows 47 million Medicare beneficiaries to electronically view, download and print their complete medical records, Federal Computer Week reported. The feature is available on the MyMedicare website. The option is similar to the Blue Button program on the Department of Veterans Affairs’ MyHealthVet website. Since VA’s Blue Button feature was introduced in August, more than 60,000 veterans have downloaded their medical records.

For years, consumers have stated their demand for EHRs with views such as as “if I can get money from an ATM all over the world, why can’t I get an electronic copy of my health records?” or “when I go to the doctor’s office, why do i have to fill out the same forms over and over again?” As consumer awareness of EHR deployment increases, they will more and more expect physicians to implement them in their own practices. As consumer awareness of EHR deployment increases, they will more and more expect physicians to implement them in their own practices.