As part of last year’s economic stimulus act congress passed the Health Information Technology for Economic and Clinical Health Act (HITECH). “HITECH broadens the scope of privacy and security protections already available under HIPAA. This law also increases the potential legal liability for non-compliance and provides for more enforcement. HITECH requires data breach notification for unauthorized uses and disclosures of “unsecured PHI” (unencrypted personal health information). These breach notification requirements are similar to most state data breach laws related to personally identifiable information. For those health providers with an electronic health record (EHR) system in place, patients have a right to access their electronic personal health information. The patient can also have their records be sent to a third-party for a fee that is equal to the labor cost to produce. Additionally, HITECH has changed it so that business associates (e.g. accounting firms, billing agencies, law firms) of those organizations subject to HIPAA (e.g. health care providers, pharmacies) are now subject to the same data privacy and security requirements, including the civil and criminal penalties, as those HIPAA regulated organizations they work with.” Quotation from Lawbrain. I corrected the typos in the original. The law sounds like it’s designed to protect privacy and make it easy for patients to access their electronic medical records .
Well, there’s more to this act. There are incentives to use certified EHR technology. Certified by whom. Well, HHS of course. Health care professionals and hospitals can collect as much as $27 billion over 10 years they meet the meaningful use objectives set by HHS. The final rules for “meaningful use” were released July 13 by Secretary Sebelius. When the act was proposed it was said to offer savings of $12.5 billion. So it appears that we’re going to spend $27 billion to save less than half that amount.
[The following quotation is from the Medical Economics article linked above.] “As much as $27 billion may be expended in incentive payments over ten years. Eligible professionals may receive as much as $44,000 under Medicare and $63,750 under Medicaid, and hospitals may receive millions of dollars for implementation and meaningful use of certified EHRs under both Medicare and Medicaid…the final rules divides the requirements into a core group of requirements that must be met, plus an additional “menu” of procedures from which providers may choose.” Sounds like a Chinese restaurant.
Why is the government going to spend what used to be a lot of money to encourage doctors and hospitals to do what they were already in the process of doing without incentive payments? The electronic medical record was going to happen all by itself. It will now happen the way bureaucrats in Washington think best. I don’t know if their way is the best way; past experience with federal rules will likely color your estimate of how effective the rules will prove. But there’s going to be a big payoff for doing it the fed’s way. Hospitals and doctors will soon be besieged by purveyors of courses and seminars designed to maximize their take from this new incentive program. It’s virtually certain, however, that over time these incentives will turn into mandates. If your electronic medical records don’t pass government muster you’ll likely discover that you don’t qualify for Medicare or Medicaid payment.
Patients and purveyors of medical care can take heart that CMS is only going to spend a trifling sum ($27 billion) on this new program. It’s a rounding error given our once and future spending on medical care.
Somehow this reminds me of a rural county meeting about water. Wells had to be redrilled deeper and deeper, some even to the drillers’ maximum of 1,000 ft. Lots of $$$$ One lady growled to the moderator, “There’s a water hog in this valley and we all know who it is……you!!! you!!! bureaucrat!!!!!! The county of course, continued to let the wealthy hog pull out 1,000 gallons a minute from his various wells and people had to drill deeper. Somehow, I think of the government as a water hog. And the lady’s furious outburst expressing frustrations of all of us less volatile persons. And someday, only the hog will have water. To own the only source of water…….what power!!
Most likely this is a lousy analogy!! Or is the government a medical info hog???
It was really good post lot of useful information. On the point of usability and defining the term ‘meaningful use’, I would add further that the medical practitioners are looking to avail of this federal incentive by trying to comply with the definition of meaningful use but at the same time EHR providers are looking at their own set of profits.
This misunderstanding is mostly I believe as a result of wrong interpretation of the federal guidelines. The EHR providers need to look at these guidelines from the prospective of the practitioners who deal with different specialties.
Each specialty EHR has its own set of challenges or requirements which I believe is overlooked by im most EHR vendors in a effort to merely follows federal guidelines. This is resulting in low usability to the practitioners, thus less ROI, finally redundancy of the EHR solution in place.
I think ROI is very important factor that should be duly considered when look achieve a ‘meaning use’ out of a EHR solution. Though one may get vendors providing ‘meaning use’ at a lower cost, their ROI / savings through the use of their EHR might be pretty low when compared to costlier initial investment. Found a pretty useful ROI tool that is pretty customizable and easy to use. It also accounts for the different specialty EHR’s too.
Also the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners.
Looking the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models.
Also I think the REC’s are going to be point of contention looking ahead, towards a successful EMR deployment.
On the issue of REC’s competing against each other, I feel this will result in a healthy competition, if they don’t get biased for a particular EHR vendor. I believe these REC’s should set their own unique business model, as discussed above within the guidelines set-forth in the HITECH act.
This would result in each REC having a set of vendors with similar offering , yet maintaining their own unique selling point.
Each EHR vendor should have their own interpretation of HITECH act, using which the REC’s can quote or compete for the jobs.
With all the money the government is throwing around these days, a billion is not what it used to be. Hopefully saving peoples lives through improved outcomes will be a benefit that loved ones will appreciate.
I’m in the Healthcare IT field myself and also enjoy the Opera. I lived in Santa Fe for many years and I remember watching the sun set as the music came up, gives me goose bumps. I did some early computer projects for John Crosby in my youth and remember the 25th Anniversary of the Santa Fe Opera like it was yesterday. Hard to believe they just celebrated their 50th. Time flies… Alfred–