Pardon my cynicism, but I'm not overly impressed with the proposal to extend the timeline for Stage 2 of the Meaningful Use program and delay implementation of Stage 3 by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT.
What's going on with the Veterans' Administration (VA) these days? The VA, with its vast electronic health record system, seemed ahead of the curve. It was a trendsetter, spearheading patient access to EHRs with the adoption of its MyHealtheVet access pilot. It increased veterans' access to mental healthcare by launching a videoconferencing program. Veterans, who have long suffered with overcrowded emergency departments, understaffing, and other problems in accessing care, finally were getting an innovative, sophisticated health benefit.
Until they weren't. Now it seems that the VA has gone rogue on us when it comes to EHRs.
There appears to be a big disconnect between desire and reality when it comes to Stage 2 of the Meaningful Use Incentive Program. On one hand, you've got the Office of the National Coordinator for Health IT, which earnestly wants to forge on with Stage 2 on time in January 2014. Stage 2, as you may recall, has already been delayed once. On the other hand, you've got the reality that a lot of electronic health record products are not yet certified for the 2014 edition software that supports Stage 2 of the program.
Sen. Rob Portman's proposed "Behavioral Health Information Technology Coordination Act," introduced last week, would expand the Meaningful Use incentive program and adoption assistance to psychiatric hospitals, substance abuse clinics and other behavioral health providers. With so much publicity these days on health insurance coverage for the mentally ill, and the all-too-common news reports about the mentally ill not receiving needed treatment, you'd think that senator's bill would garner at least some attention. However, it's received very little press.
I'm never surprised when readers comment on my editorials, either on the FierceEMR website or to me personally. I try to address timely, thought-provoking topics that give readers pause, as well as the opportunity to weigh in.
But I was a bit surprised when a news story I wrote last week about a study published in Health Affairs quickly generated comments. The study predicted, based on its analysis of electronic health record literature, that if just 30 percent of community-based physicians fully implemented health IT in their offices, the demand for physicians would decrease 4 to 9 percent.
Evidently, the gains in efficiency claims in this study hit a nerve, with commenters strongly disagreeing with this conclusion. What I also was expecting--and haven't seen--was comments on the other conclusion of the study: that EHRs will cause significant physician job loss.
I read with great interest my colleague Ron Shinkman's thought-provoking commentary about how the 25 states that have refused to expand Medicaid eligibility pursuant to the Affordable Care Act and rejected billions of federal dollars could ultimately degrade the quality of their patients' care. Shinkman, editor of FierceHealthFinance, noted that hospitals in at least one of these states have already started laying off staff, which often impacts the quality of care provided. I worry that the Meaningful Use incentive program is creating a similar dichotomy.
What happens when a provider attests that it has meaningfully used its electronic health record, receives its incentive payment, and later discovers on its own that the attestation was faulty?
Electronic health records are, for the most part, reliable. But one of the downsides to EHRs is that when they don't work, the hospital is at a standstill. ... And that's how our government has shut down.