In a recent article in a national publication, a member of our physician community raked up a debate by declaring the Electronic Health Records (EHR ) mandate to be a debacle and argued that EHR’s actually harm patients. These are bogus objections that continue to be raised by a community that clings to its past entitlements and easy money attached to little or no accountability. But it also exposes an undercurrent of resistance to change that the general public should be worried about.
Under the provisions of Obamacare, The Center for Medicare and Medicaid Services (CMS) has mandated the use of EHR technologies for qualifying for additional incentives under Meaningful Use criteria. This includes maintaining patient medical records, sharing them with patients as well as other health systems, and using them for treatment decisions. Individual physicians and practices now have to comply as well, and a failure to implement EHR’s within a certain date will result in Medicare reimbursements being reduced by 1-5 percent progressively with time till the end of this decade.
On the face of it, this would appear to be a good thing for all patients, and also for physicians who can now pull up patient medical records on their laptops or handheld devices at the point of care.
According to a Rand Corporation study, the three key objections against the implementation of EHR’s:
--It costs too much to implement an EHR system: Yes, it costs money to implement any new software. Given a choice, physicians would prefer not to use email or even the telephone because all of these things cost money and have no direct relation to the treatment of patients. What these same physicians also fail to mention is that large hospital systems have been extending significant subsidies to small physician practices in order to help them address the costs.
--It takes time away from patient care: Physicians love to talk about how much they care about being with their patients. However, they also routinely overbook their schedules with the sole intention of increasing patient visits and claiming additional reimbursement. EHR’s can actually aid their productivity by reducing the time it takes to pull up medical history, so that they have more time to spend on actually talking to their patients.
--EHR systems are hard to use and are not secure: There may be some merit to this. No one is making claims that EHR systems are perfect.
In sum, it would appear that their primary argument is that the implementation of EHR’s results in lower quality of care and higher costs.
However, there are a few key aspects that these physicians prefer to not acknowledge when making these arguments:
--Shared electronic medical records can reduce expenses: Physicians routinely bill for duplicate medical expenses, such as tests, that would be avoided if the test results can simply be pulled up electronically. This should logically reduce healthcare costs at a system level.
--Quality of treatment can improve significantly: When a complete medical record is available about a patient, including details of visits to multiple healthcare professionals, the quality of diagnosis and hence treatment decisions should improve greatly. This improves patient safety and reduces medical errors, since everyone has access to the same set of data.
--EHR’s can enable preventive diagnosis and early intervention that reduces costs and improves patient health: Enter healthcare analytics. Having patient medical records in an electronic system enables this data to be analyzed for preventive and early action, improved disease management, and reduced hospitalizations. The whole notion of population health management rests on this premise and is hard to argue with.
At the end of the day, the biggest benefits of technology will accrue from our ability to integrate patient medical information from EHR systems, and analyze them in conjunction with data that is going to be available through wearable devices and other consumer health technologies. If some parts of our physician community do not get this, we need to leave them behind and move on.
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