Accelerating e-Prescribing

Will Incentives Work to Drive Adoption?

Howard J. Anderson, the Executive Editor of Health Data Management, recently noted that "consultants, analysts and software vendors are urging physician group practices to begin work immediately on selecting an electronic health records system. That's because clinics need to have a qualifying EHR system in place by the start of 2011 to qualify for maximum incentive payments under the federal economic stimulus package."

But some group practice administrators are taking a "wait and see" attitude before plunging into planning. And other administrators want to learn far more details about the incentives before they plot a strategy.

According to William Jessee, M.D., president and CEO of the Medical Group Management Association, because there are so many questions about the stimulus package's details which remain unanswered, clinics should wait to see all follow-up regulations before plotting a strategy.  "It's one of those deals where the devil is in the details," he adds.

The American Recovery and Reinvestment Act of 2009 includes $17.2 billion in Medicare and Medicaid financial incentives for hospitals and doctors using qualifying electronic health records systems. Practices must apply for either Medicare funding or Medicaid funding, not both.

Physicians who make "meaningful use" -- which is still undefined -- of a certified electronic health record system can qualify for up to $44,000 in Medicare incentives, more in certain underserved areas. And as of late March, it was not yet certain that the Certification Commission for Healthcare Information Technology (CCHIT) would, in fact, be designated as the official certifier of systems.

The economic stimulus package also includes financial penalties for practices that resist automation. It calls for Medicare payment cuts starting in 2015 for clinics that lack a qualifying EHR system. "But my reaction is people are much more concerned about 2009 and 2010 than any potential cuts for 2015," Jessee notes. "The slow economy, tight credit and potential cuts in Medicare reimbursement next year are more on the top of people's minds now."

Many physicians in group practices are heeding MGMA's advice, awaiting more details from the federal government before investing in EHRs. While some physicians perceive that electronic records will slow them down, others are more receptive to automation to improve efficiency, he acknowledges. "So we're at gridlock right now."

The Medicare and Medicaid incentives should drive physician adoption -- as soon as some of the unanswered questions have been addressed.

AMA Launches Online Tool to Assist Docs with e-Prescribing

According to Health Data Management (HDM), the American Medical Association is offering a free online learning center to provide physicians with information about electronic prescribing. The Chicago-based professional association’s learning center includes information on vendors’ products, including prices and features; calculators to estimate time savings and determine potential Medicare e-prescribing incentive payments; updates on federal and state incentive programs; and resources doctors can use to create an implementation plan.

The AMA's online learning center states that "There's never been a better time to implement an e-Prescribing system. Medicare is now offering a financial incentive to prescribers who do so. And more and more forms of financial assistance and support are becoming available to help make the change possible." 

e-Prescribing is starting to catch on with an estimated 100 million prescriptions transmitted electronically this year by more than 74,000 prescribers. Successfully implementing e-Prescribing (solutions) can directly benefit the quality of care you provide and the administrative efficiency of your practice.

Some of the key benefits discussed on the Web site include:

• Access to your patient's medication history information
• Time savings and more productive use of your staff
• Alerts and reminders that help you make better clinical decisions
• Greater convenience for your patients

Certain sections of the learning center are available only to AMA members. The center can be accessed at ama-assn.org.

HHS Secretary Designate Kathleen Sebelius Talks HIT

National interoperability standards for health information technology are key first steps in developing electronic health records and advancing health reform, said HHS Secretary Designate Kathleen Sebelius today told the U.S. Senate Committee on Health, Education, Labor and Pensions.

“Step one is to get a platform,” she told the panel, chaired by U.S. Sen. Edward Kennedy, D-Mass., “Investments are not worthwhile unless there’s a platform.” Governor Sebelius (Kansas) testified as senators began formal consideration of her nomination by President Barack Obama to lead the U.S. Department of Health and Human Services. She is also scheduled to testify before the U.S. Senate Finance Committee, which will vote whether to recommend her for the post. A full Senate vote could occur before the chamber goes into April recess.

Gov. Sebelius’ comments were in response to questioning from U.S. Sen. Barbara Mikulski, D-Maryland, who said there was “great fear over interoperability.” She said targeting billions of dollars for HIT expansion without clear national standards could lead to a “techno Katrina,” and a “fiscal and case management boondoggle.”

Gov. Sebelius said the interoperability issue would a top priority for HHS, if she is confirmed. “In the next five years HHS will set the standards for privacy and interoperability, test models, and certify the technology and offer incentives for hospitals and doctors to adopt it,” she testified.

The American Recovery and Reinvestment Act enacted in February provides $19 billion for further development and adoption of electronic health records, including over $17 billion in direct incentives to physicians and hospitals for implementing HIT solutions. President Obama is calling for widespread adoption of the technology by 2014.

In her testimony, Gov. Sebelius reiterated the Obama Administration’s focus on health care reform as an essential component of economic recovery.  “I share the President’s conviction that health care reform cannot wait, it must not wait and it will not wait another year. Inaction is not an option,” she said.  “Unless we face costs at the same time we are expanding coverage we really haven’t made as much progress as we can and we won’t have provided the pathway to prosperity for American workers, for American business, and for American families,” she said.

The governor also called for expanded access to health care in rural areas and reorienting physician payments to increase the number of primary care physicians.  Gov. Sebelius also emphasized prevention activities and personal responsibility. She called the childhood obesity epidemic a “rampant crisis that we need to address.” 

“Individuals have responsibility about what they eat, how they exercise, about the choices they make with particularly tobacco and the more we can drive that through the auspices of the agency through prevention efforts I think the better off we’re going to be in the long run,” she said.  Another priority, she said, would be providing resources for prenatal care for at-risk pregnant women.