Just Trying to Do the Right Thing…
In February of 2009, members of the Federal Government set the lofty goal of revolutionizing health care management in the United States. Mitigating the trepidation in physicians and hospital administrators associated with making such a significant transition, the government incentivized electronic health record adoption by offering upwards of $44,000 in federal stimulus money to participating providers. The passing of the ARRA/HITECH marked the beginning of the government’s efforts to get the healthcare industry to a place in technology-use where other industries have been for nearly two decades, but the road to adoption hasn’t been without bumps and sharp turns.
Small physician practices, clinics, hospitals and health networks spent the greater part of 2009 and 2010 trying to grasp the “what and how” behind meeting these expectations and then moved either towards satisfying or resisting the federal mandate to integrate electronic medical record systems into their practices.
While some medical practitioners are encouraged to achieve meaningful use simply because they see EMRs as the best way to go about improving patient care and facilitating physician-patient interaction, the promise of stimulus funding – or fear of financial penalization if they do not abide by “meaningful use” health technology adoption – has served as a main driving factor for the majority of adopters. And even the savviest practitioners have significant questions about which of the 300+ EHRs will be right for their business needs – what are some of the unseen costs? How much money is too much money for an EHR? How will the EHR integrate into my practice management? Are there annual updates and renewal costs? Will I have to train new staff members? The list goes on and on, but one question few have asked is – what happens if the Federal Government takes the incentive away?
The House’s Spending Reduction Act of 2011 (H.R. 408) shines a light on some substantial gaps surrounding EHR adoption that providers should take seriously. The bill—introduced in January of this year—seeks to reduce federal spending by roughly $2.5 trillion by cutting financing for certain government programs. One cut may come in the form of “taking back” the $27 billion built into the federal budget for disbursement to healthcare providers leading the way in EHR adoption. This serious possibility was discussed in a recent article in Healthcare IT News.
The threats associated with a tough economic time for the country mean that stimulus funds are always in jeopardy, but for many hospital and health network administrators, news of the House bill comes after they’ve invested upwards of $35,000 for initial EHR purchases and nearly $1,500 per month for ongoing support. In addition to exorbitant costs for initial set up and maintenance with large EHR vendors, physicians and hospital administrators have to weather EHR certification processes with vendors which sometimes produce additional costs.
Amidst the stimulus debate, physicians and administrators are caught somewhere in the middle. They are understandably hesitant to continue to move toward electronic medical record system integration due to high cost and waning guarantee of financial reimbursement, but current legislation requires they achieve “meaningful use” of health information technology systems by 2014. How do they do the right thing?
It is important to keep in mind that EHRs were never intended to be the “silver bullet” in improving the quality of healthcare so whether managing a network of hospitals or a solo practice, making the decision to adopt electronic health record technology should be driven by the needs of the practice’s physicians. EHRs help physicians better care for patients by organizing data, providing better access to the data and eventually connecting the data across health systems. The intention is to simplify the otherwise cumbersome processes to save time for health workers so that they can better focus on caring for patients.
The true test of a good EHR is if it is both affordable and usable. In order to realize the benefits of EHRs, programs cannot be so complex and confusing that they actually require more time to navigate than paper charts or leave physicians with little time to actually use the information to the advantage of the practice and patients. Concurrently, programs should not be so costly that they severely limit the capacity of a hospital or clinic to make updates to systems or that they would successfully bankrupt a practice should federal incentives cease to exist. Ideally, a practice’s information technology decision-making team will choose solutions that support quality of care, facilitate record keeping and mobility and advance evidence-based medicine while maintaining scalability per the unique needs of the clinic or hospital.
Today, when the EHR industry is growing rapidly, healthcare executives are tasked with wading through the clutter to find a vendor that best suits the needs of the practice and physicians. While proponents of the ARRA/HITECH Act assert that the SRA bill will not likely pass, other barriers to effective EHR system integration continue exist. So if you just want to do the right thing, select an EHR that fits your practice – and that is affordable and usable for you and your staff.
While budget cuts are always a possibility, H.R. 408 is nothing more than a posturing piece by the Republican Party that they know will never get passed through the Democrat controlled senate.
It is quite literally the republicans cutting everything they don’t like and keeping everything they do.
It removes funding for unemployment, COBRA, Medicare, Medicaid, state relief, while also removing the salary cap for the executives of companies that received stimulus money. – So it takes away a poor person’s ability to survive and gives the Executives of bailed out companies a pay raise. How Republican of them.
Freezes the pay of federal workers until 2015. – Sorry that inflation is skyrocketing, but your already low pay rates will have to stay there.
Defunds PBS, NPR, and any other cultural benefit. – Because Sesame Street and classical music is bankrupting the country…
Removes subsidies for organic farmers, but keeps those in place for the mega-corporation farm companies. – Friends of the little guy as you can see.
Repeals the Davis-Bacon Act which required contractors working on federally funded/assisted contracts for construction, repair, alteration, etc to provide fair wages to workers based on where the work is being performed. Meaning you can’t pay the worker from Iowa minimum wage when you ship him out to California to work, where the average wage is double minimum wage. – Can’t let all those construction workers get a fair wage you know. They might buy something.
Repeals the Elementary and Secondary Education Act of 1965 – The single most far reaching education legislation ever passed. It is legislation that guarantees money to elementary and secondary (middle/high) schools along with stating that there will be no national curriculum. – So the Republicans are trying to defund every public school in the country and try to say what can and cannot be taught in the overcrowded schools that will inevitably happen. All our children can be as smart as Sarah Palin. I know I’m excited, aren’t you?
Stops the funding for Medicaid FMAP. The act that increased the amount providers are paid by Medicaid. – Can’t actually pay providers for treating the poorest people in the country.
Bans construction of federal building in Washington D.C. – Because the building of federal facilities won’t employ anyone…
Terminates the Presidential Election Fund – This has mixed reactions. 1. The gov’t should receive every dollar collected from taxes and shouldn’t have to lose $3 for every box checked on a tax return. 2. This means more funds for elections have to come from party supporters, where the most amount of money is sourced from large corporations, in effect BUYING politicians. As money equals advertising, advertising means exposure, exposure equals votes. Our political system is broken, simple as that, and it isn’t going to be fixed or ruined on this little piece.
Amends the Federal Agriculture Improvement and Reform Act of 1996, which funded small rural farms and bioenergy producers. – Putting more money in the pockets of huge farm corporations and the oil/coal companies by making bioenergy production less competitive. There’s plenty of oil, just keep burning it.
Amends several acts to raise the price of sugar and decrease the price of high fructose corn syrup. – More lovely big corporation hand outs to the people that study after study are showing are causing country wide medical problems.
Defunds marketing and loan assistance for Mohair producers. – In other words, make a natural material more expensive than polyester, a plastic made from oil. Are you seeing a trend here?
Conduct a Federal Real Property Disposal program. – This one I am in favor of, it requires a government office to sell unused Federal property.
To release control of Fannie Mae and Freddie Mac if they are found financially viable and to take control of them again if they go under. – So the republicans want to get rid of a federal program that gives people home loans if it makes money and take it back if someone screws it up and drives it into the ground. In other words hand over a free company to the bankers that screwed our economy and let them screw it up, then give it back with no consequence. Yeah, great idea.
Limit federal printing, government travel, and federal vehicle costs. – Fine with me, they can wait a couple of years between cars like the rest of the country. Although this is a double edged blade. As the government is the single largest consumer in the country and since it subcontracts to print things, maintain, and buy their vehicles this means that many industries are going to take a pay cut. The question is which is more, the tax revenue generated by subcontracting or the debt reduction by limiting the spending? A math equation I am sure they haven’t actually done.
Repeals the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. – Can’t be lowering the cost of healthcare, educating patients, or anything like that with insurance companies on the republican payroll.
“Amends the Internal Revenue Code to require every individual, regardless of income tax liability for the taxable year, to designate a specified overpayment amount to reduce the federal deficit.” – Yep, read it again. The “no new taxes” “trickle down” republicans want you to be REQUIRED to specify how much of your taxes you want to OVERPAY to help them pay off the massive deficit they managed to pile up. And so you are aware. That is a quote by the way, not me summarizing it. Straight from the mouth of Republicans.
Amends the CAA of 2011 to make any future legislation to fund healthcare acts impossible. – Defund federal healthcare spending and then make it illegal to do again. The Republican Party, the party of the corporations, PEOPLE, I MEAN THE PARTY OF THE PEOPLE. Freudian slip…
Reduces and amends the formulas used to calculate the amount of discretionary spending on everything BUT THE MILITARY. – The military contractors are allowed to keep their big paychecks while everything else gets cut. We already spend more on military than any other country and the majority of the world combined, but we can’t let those warmongers go hungry.
Note: I have no political affiliation. I am not a Republican, Democrat, Tea Party nutjob, Libertarian, Conservative, or Progressive. I am just a well educated American that can see through all the BS.
EHR and EMR are on the table, however, there still is a long road ahead for the meaningful use. It is great that there are mandatory stipulations to help break these two issues into viable working sources in the medical industry.