Will Big Medicine slow down EHR evolution?

For dental professionals concerned about fiscal and technological nightmares associated with electronic health records, it should be pointed out that the Boston Globe article, was, for the most part, upbeat in tone, touting improved patient safety and hospital efficiency as dividends of the enormous investment.

Jun 1st, 2015
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The Boston Globe covered a $1.2 billion grand opening last weekend at Brigham and Women’s Hospital, which is southwest of the city. No, it was not a new wing for the hospital, or any newly constructed structure.

The newspaper covered the hospital’s system for computerized health records. The records are part of a system covering 10 hospitals and 6,000 doctors. The initial estimate for the development and implementation of the electronic record-keeping system was for $600 million — a hefty price tag itself. The firm that developed the system sent approximately 450 software specialists to a “sprawling makeshift command center” to help facilitate the technological change.

The newspaper reported, “Most of the issues were minor and expected, including problems logging into workstations and printing documents, hospital officials said.”

One medical professional interviewed by the newspaper said, “This morning I felt a little disconnected. But I think when I get used to it, it’ll become second nature.”

For dental professionals concerned about fiscal and technological nightmares associated with electronic health records, it should be pointed out that the Boston Globe article, was, for the most part, upbeat in tone, touting improved patient safety and hospital efficiency as dividends of the enormous investment.

The grand opening described above, though, arrives at a time when compliance with electronic health records still remains vigorously challenged by perhaps the most key player in the health-care arena — physicians.

For example, while the Boston hospital transformation was underway, several newspapers published a syndicated column titled, “Why doctors quit: Electronic health records.” The article, which was written by a physician, quoted a medical colleague as saying, “The introduction of the electronic medical record into our office has created so much more need for documentation that I can only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.”

The government is listening to disenchanted health-care professionals. The U.S. Department of Health and Human Services is considering allowing for more time to comply with required components of electronic health records. The relief is not just aimed at health-care professionals. It’s also trying to allow technology companies more time to create better software.

USA Today quoted a hospital administrator as saying “The problem is we're in the EHR 1.0 stage. They're not good yet. They (federal government) spent billions of dollars to finance the implementation of flawed software."

Mark Hollis, CEO of MacPractice, serves on an advisory committee for federal oversight of electronic health records. He said the proposed rules are part of a "listening and responding" stage where all parties attempt to make health-care data collection as easy as possible. He anticipates requirements for EHRs to move forward by August 2015, once the current comment period ends.

Hollis also pointed out that medicine is challenged by the existence of dozens of specialties, where terminology and care protocols affect electronic health records "in the way they collect data."

Hollis emphasized an often overlooked aspect of required compliance with electronic records. "There's a penalty, but there's nothing that requires participation. The penalty is that Medicare payments will be reduced, and they will get paid less" if health-care providers are not using an EHR system.

Minnesota and Massachusetts are actively considering exemptions for health-care professionals on a state level. Minnesota recently exempted solo practitioners from the requirement of interoperable electronic health records. The 2009 federal HITECH Act states "all hospitals and healthcare providers must have in place an interoperable electronic health records system within their hospital system or clinical practice setting.”

One health-care advocate in Minnesota said, "Many small clinics and practices cannot afford the cost of the EHR system, and many practices do not want to make their patients' data accessible online."

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