EMR Adoption

Doctors that are keeping abreast of the news, going to conferences, and speaking to consultants have to be wondering how they can be eligible for the government’s economic stimulus package called the American Recovery and Reinvestment Act (ARRA). This legislation was announced in February of 2009 as part of President Obama’s effort to rein in future health care costs. If you are not familiar with any of this, then this article will be even more important for you.

There is approximately $19 billion dollars set aside for Health Information Technology (HIT) in the effort to modernize the U.S. Healthcare System. The ARRA stimulus package includes incentives to doctors for computerizing their patient clinical records into an electronic system know as EMR (electronic medical record) and also known as EHR (electronic health records) system. Doctors will become eligible in 2011 to receive, in essence, a “rebate” based on their Medicare billings. However, there is a lot of misinformation out there and—buyer beware—health information technology is very complex! Trying to understand it all is not only difficult but is a moving target. Technology continues to change at hyper speed and it is crucial for you to stay informed in order to compete. This article is meant to inform you about:

• how you could be eligible for the government stimulus money;
• what you should be careful of in setting up criteria for getting the correct system;
• why a wrong decision on an EMR would be much more costly than any money the government will grant you;
• why, regardless of any stimulus money, you should get computerized to give you much more profit and frankly, allow you to continue to practice as a pain management doctor.

Brief History

Health Care in the U.S. is undergoing a massive overhaul of historic proportions. The current economic depression in the U.S. and the world has brought to the forefront the increasing cost of U.S. Health Care which was over $2.2 trillion dollars in 2007 and is projected to double to $4 trillion dollars over the next decade. According to many studies, the increase in health care costs has not improved our ability to provide affordable, efficacious care to every U.S. citizen. In fact, according to the National Scorecard on U.S. Health System Performance published by the Commonwealth Fund (a private foundation that studies health care performance in the U.S.), the U.S. is losing ground in providing access to health care, as well as uneven quality to those who do have access. You see it in the news everyday. Millions of people do not have access to affordable health care. Health is a serious and expensive problem and President Obama has made it the most important issue for his administration to solve.

Health Insurance Portability and Accountability Act (HIPAA)

Landmark legislation began with HIPAA in 1996, which started the process of patient record portability and patient access, and includes privacy/security measures. It has affected the way we do business in America. The HIPAA rule provides federal protection for a patient’s personal health information and gives patients a wide range of rights with respect to that information. It is also meant to allow disclosure of health information that is necessary for patient care and other important purposes.

It is my belief that you cannot be HIPAA-compliant if you have paper records. Such records can easily be stolen, altered, shared with parties or destroyed without any tracking and control. With paper records, it is difficult to have password protections and audit trails. HIPAA has really started the process towards the computerization of health care.

Medicare Prescription Drug, Improvement, and Modernization Act (MMA)

To combat the high incidence of medication/prescription errors that has contributed to patient fatalities, MMA was passed in 2003. This act is slowly transforming manual prescribing into electronic prescribing (ePrescribing). Unfortunately, the DEA has not gotten on board with this, so as of right now, pain doctors cannot ePrescribe class II drugs. ePrescribing will become increasingly important and we all hope the DEA gets with the times to better understand how technology can make it safer and provide better security in deterring drug-shopping patients, as well as thwarting the efforts of illegal drug suppliers.

ePrescribing can put you in touch with your patient’s drug history and current medications which, in turn, will give you more up-to-date information to ensure your patient is not drug shopping. It will also provide additional crosschecks to ensure your prescriptions do not have adverse reactions with your patient’s other prescribed medications.

Incentives for the Use of Health Information Technology

In 2004, President George Bush signed Executive Order 13335 (Incentives for the Use of Health Information Technology) which cleared the way for sweeping changes in order to modernize our health care system. This legislation enforced the selection of a Chief of Health Information Technology (HIT) to come up with a game plan for such HIT modernization. One of the most important problems has been the many different “standards” for linking systems and identifying methods of inoperability between such systems. Basically, in the U.S., there are disparate software and hardware systems that are incompatible. In fact, most of the systems do not talk with each other. As I mentioned in an earlier article that I wrote a couple of years ago, there are more billing software systems in the U.S. than there are different languages that people speak in the world The problem is that each billing/practice management system, in essence, “talks” their own language which makes it difficult to interface with other systems.