Medical and insurance industry pundits agree the transition to electronic medical records will result in substantial cost savings for patients. Huge medical groups and publicly-traded hospital corporations — the first healthcare groups to turn mountains of paperwork into racks of computer servers — talk about millions of dollars in annual paperless savings with their shareholders.
But some hospitals and doctors think the Obama administration is moving too fast in its efforts to promote the transition to electronic health records, according to the New England Journal of Medicine.
At issue is a proposed regulation that spells out what hospitals and health providers must do in order to receive incentive payments for “meaningful use” of electronic health records. Thanks to the economic stimulus legislation, the Centers for Medicare and Medicaid Services (CMS) will pay up to $17 billion starting in 2011 to hospitals, doctors and other health providers that meet these standards.
To be clear about what amounts to an economic mandate, by 2015, Obama has authorized CMS to cut Medicare reimbursements to hospitals and providers that aren’t “meaningful users” of electronic medical records. What isn’t clear is what “meaningful users” may eventually mean. For now though, CMS just released a list of some 20 electronic medical records standards that providers must meet in order to qualify for the incentive payments.
After a few weeks of reflection, the American Hospital Association balked at the standards. The proposed rules are too stringent, the organization contents, and would penalize hospitals that already are using technology to reduce medication errors, track outcomes and collect basic patient health information without a mandate or incentive to do so.
“As proposed, the current regulations may actually make it more difficult for hospitals and doctors to adopt health information technology,” said Rick Pollack, the association’s executive vice president. “Unless significant changes are made and timelines re-examined, it is unlikely that the vast majority of hospitals can meet the proposed standards.”
While experts believe the expanded use of electronic records will improve the quality and efficiency of health care, and improve patient safety, hospital administrators and physicians know all too well that the process will amount to more than simply scanning pages and moving on. In a government-funded survey published last year by the New England Journal of Medicine, only about 17 percent of all doctors in the United States are currently using an electronic medical records system.
Some believe that once the medical record transition gets going, peer pressure will drive compliance.
“Electronic medical records will accelerate and facilitate health information technology adoption by more individual providers and organizations throughout the health care system,” said Dr. David Blumenthal, national coordinator for health information technology, in a recent interview with New York Times.
Since three-fourths of U.S. doctors work in small practices not aligned with deep pockets of hospital corporations or insurance companies, the conversion to electronic medical records amounts to a major cost that’s long deferred. Technology isn’t the problem. Money, time and training are the culprits.
“There’s no way small practices can effectively implement electronic health records on their own,” said Dr. Farzad Mostashari, assistant commissioner for the New York City health department. “This is not the iPhone.”
