PERC - Health Information Technology

Thursday, April 11, 2013 02:10 PM

Electronic Health Records and the EHealth Evolution/Revolution

The Bush Administration founded the Office of the National Coordinator for Health Information Technology in 2004 with the express goal of having every provider in America utilizing electronic health records (EHR) by 2014. The current administration has continued the focus, providing billions of dollars in funding for health information exchange (HIE) and EHR incentives in the 2009 federal stimulus bill. To receive the money, physicians must demonstrate “meaningful use” of an EHR by 2014. (Click here for an explanation of meaningful use). Physicians who don’t do so by 2015 will lose a percentage of their Medicare payments.

There are a lot of good reasons to implement an EHR and HIE besides the money. Used to its full potential this technology can vastly improve the quality, efficiency and safety of care, as well as the patient experience. New reimbursement models and care systems will reward physicians and other providers who are on top of their own data and metrics and have the ability to interface with colleagues and patients. Physicians who ignore these transformative changes will lose out quickly.

That said, these systems require a significant investment of time and money. That’s why the time to begin working toward meaningful use of an EHR is now – while federal funds and other types of assistance are available.

Physicians may begin registering for the EHR incentive program in January 2011. Physicians must choose an incentive either through Medicare or Medicaid, and each physician may change once during the life of the incentive program. For Medicare the maximum incentive is $44,000 over five years; more if in a health care shortage area. The incentive calculation is based on 75 percent of the allowable charges (Medicare, coinsurance and patient share) in a payment year, subject to maximum payments. Medicaid incentives are only available to professionals who meet an “eligibility” threshold of 30 percent of patient encounters that are Medicaid patients (20 percent for pediatricians). The maximum incentive is $63,750 over six years. This is based on a percentage of the amount you spend on EHR purchase, implementation and ongoing support. To qualify for the maximum incentive, physicians must demonstrate meaningful use by October 2012. After that date, the maximum payment gets smaller each year. The first payment will be made to qualifying physicians for the Medicare incentive in May 2011. The first payment for the Medicaid incentive will likely occur later in 2011.

Federal funds also are being used to build Colorado’s HIE infrastructure – essentially the “digital superhighway” that providers will use to exchange information. In Colorado, these funds went to the Colorado Regional Health Information Organization (CORHIO), the organization designated by Gov. Bill Ritter to oversee and implement Colorado’s HIE. With the help of additional funds from The Colorado Health Foundation, CORHIO will implement HIE across the eastern part of the state, while Quality Health Network (QHN) will concentrate on the western part of the state. Work is already underway in the San Luis Valley, Colorado Springs, Boulder, and other areas of the state. CORHIO will work with physicians to determine (a) if their existing EHR will interface with the HIE, and if not, what needs to happen to connect or (b) what questions physicians should ask a vendor if considering purchasing an EHR to ensure it will properly connect to the state’s HIE platform.

CORHIO also received a grant to form the Colorado Regional Extension Center, or CO-REC. A collaboration between seven partner organizations, the CO-REC will help certain primary care providers reach meaningful use. The law states that the RECs must prioritize services for:

• Physicians in practices with fewer than 10 physicians and/or other health care professionals with prescriptive privileges that are primarily focused on primary care.
• Physicians, physician assistants, or nurse practitioners who provide primary care services in public and critical access hospitals, community health centers, rural health clinics and in other settings that predominantly serve uninsured, underinsured and medically underserved populations.

The CO-REC partner organizations are: Colorado Community Managed Care Network, Colorado Foundation for Medical Care, Colorado Rural Health Clinics & ClinicNET, Health TeamWorks, Physician Health Partners and Quality Health Network. These organizations will help practices with areas such as workflow redesign and EHR vendor selection and group pricing agreements.

Additionally, the Colorado Beacon Consortium, a seven county Western Colorado collaboration, is one of 15 communities in the country awarded federal funding to serve as a Beacon model for use of Health Information Technology to help decrease costs and improve quality. The awarded federal funds will be used to enhance the HIT infrastructure of the Quality Health Network HIE and implement practice redesign services for participants within the area to improve physician efficiencies and effectiveness.

Finally, the EHR incentive program isn’t the only way physician practices can earn money by using health information technology. The federal Physician Quality Reporting Initiative (PQRI) provides incentive funds to practices that report certain quality measures. Incentives also are available for electronic prescribing.