EHR Incentive Payment
Submitted by Dr. JG Kaplan on Thu, 2009-07-02 18:12
The adoption and implementation of health information technology (HIT) nationally is "For the Future of Health and Care." And thus, the "American Recovery and Reinvestment Act" (Recovery Act in short) was born. Providing $19 Billion and up to $44,000 per doc to purchase and use the computer in a "meaningful" way seems straightforward, but is it really a Trojan Horse?
In an article, "EHR Financial Incentives Tied to 'Meaningful Use'" [Pediatric News. June 2009;43(6):34], "Dr. John Halamka defined it as “processes and workflows that facilitate improved quality and increased efficiency.” The same article refers to the Markle Foundation's “simple” definition of patient-centered "meaningful use," which is: “The provider makes use of, and the patient has access to, clinically relevant electronic information about the patient to improve patient outcomes and health status, improve the delivery of care, and control the growth of costs.”
It's worth reviewing their Consensus Document; it has been, endorsed by AARP, the American Academy of Family Physicians, the Joint Commission, Surescripts, America's Health Insurance Plans, and the National Committee for Quality Assurance.
However, notwithstanding the efficiencies gained with computerization, and mindful of HIPPA "protections," the EHR may be an entry to governmental oversight. I have no problem with unobtrusive feedback into my practice (and I know the value of an "episode of care" kind of analysis), but 'been there; done that' when it comes to HMOs looking over my shoulder and being judgemental—"Doc, I'm here to help ya."
- Oh, Dr. Kaplan: We see you've not immunized X patients. (Could it be that I'm not their PCP?)
- Dr. D. Mellitus: Your Hgb A1c levels? (Could it be that some of these patients lost their coverage or are noncompliant?)
- Dr. C.A.P.: Too many of your patients are being admitted to the hospital. (Could it be that many of them continue to polute their lungs?)
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