Approximately 80% of physicians do not currently use an electronic health record system. Unfortunately, this statistic isn’t surprising, given the number of barriers to adoption, including the high cost of EHR systems and the often complex process of selecting and implementing new technology. It costs about $54,000 to purchase an EHR system, with annual maintenance costs of about $10,000. The HITECH Act aims to address the high cost of adoption by providing physicians with federal incentives of up to $44,000 for Medicare physicians and up to $63,750 for Medicaid physicians, if they can meet the “meaningful use” requirements outlined in the final rule recently released by CMS.
Throughout the meaningful use rulemaking process, the American Medical Association worked to ensure flexibility for physicians in meeting the requirements to help make the process of adopting and using EHRs as smooth as possible. With this final rule, physicians have a clear outline of what they need to do to take advantage of federal incentives that can help offset the cost of an EHR system. The final rule offers many improvements over previous drafts, but challenges do remain that may make it difficult for physicians to meet the requirements, especially those in solo and small practices.
Let’s start with the good. The final rule reduces the overall number of measures physicians have to meet during the initial stage of the incentive program and lowers the high reporting volumes associated with several measures to a more manageable amount. For example, the requirement for the use of computerized physician order entry has dropped from 80% to 30% and is now limited to just medication orders.
The rule also offers greater flexibility in meeting quality measures by limiting the number of clinical quality measures physicians need to report to only those with electronic specifications. Physicians are also able to select quality measures that are most relevant to their practice. Nearly half of the quality measures approved in the meaningful use rule come from the AMA-convened Physician Consortium for Performance Improvement, so participating physicians can be assured that many of these measures were developed through a rigorous, evidence-based and physician-led process.
The objectives and measures related to administrative simplification have been removed during the initial stage of the incentive program, allowing physicians to focus on only meeting requirements that are directly related to an EHR. Lastly, CMS has adopted an approach that calls for greater uniformity and less variation between the two incentive programs in Medicare and Medicaid.
Now for the challenges. Currently there is no EHR in the market that does all the things required for physicians to successfully meet the meaningful use criteria. To qualify for incentives, physicians must demonstrate they meaningfully use EHRs for a minimum of 90 consecutive days in 2011. CMS expects EHR systems that support meaningful use to become available this fall, giving physicians less than a year to purchase, implement and begin using EHR technology in accordance with the requirements. This is no small feat, considering it can take a year or more for some physician practices to purchase and implement an EHR system.
While the final rule does reduce the overall number of measures physicians must meet, requiring physicians to meet 20 measures in the first year is still a very high bar, especially for smaller practices that are new to the technology. Those physicians who have already invested substantially in EHR technology will now have to upgrade their systems to meet the certification criteria in order to be eligible for incentives.
Despite the challenges, a properly implemented EHR system can help streamline the clinical and business functions of a physician practice and support physicians with providing coordinated, patient-centered, quality health care. AMA is committed to helping physicians overcome barriers to implementation so they can successfully adopt EHR technology in their practices and qualify for federal incentives.
Source: iHealthBeat
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