Live From the “ONC HIT 2010 Update”

How serious is the government about you instituting high tech solutions (read this as EHR) into your office?  Well let’s just say that this first phase of Obamacare is heading straight for you and your office like a runaway train with a nuke on its heels.

If the billions of dollars they have spent and are planning to spend through the ARRA stimulus package aren’t enough.  Then you may want to listen to their logic.  If money and logic aren’t enough, then you’d better be ready for the sticks and stripes to come.



The ONC has been hosting all-day seminars for the last couple of days (Dec 14 & 15), live from Washington D.C.   I listened in while I was working yesterday to see what the general status of things were and yesterday had the most topics that I thought would apply to our clients.  (You can catch session re-plays, if you would like, at http://www.tvworldwide.com/events/hhs/101214/ .  This address was where the live broadcast was being held.  I noticed that they were posting each session as a movie file there as well.  If this link fails after a bit I would suggest going over to the ONC web site proper. http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204)

That all being said, let’s break it down:  
Money, Logic, Sticks and Stripes

Money

• They expect the first EHR payments to go out in January 2011.  I couldn’t quite tell what or where those payments were going.  I say that because in the next breath they mention that the first payments due to be sent out to you physicians for meaningful use of a certified EHR will be sent out in May 2011.
• They’ve tried to make it easy to get the money this year and entice you to want to get into and stick with the program.  To do this, the reporting period for this year is only 90 consecutive days (rather than the entire year).  Do your time, sign up with your NPI and EHR certification number, submit your information, and get a check.  That is about as easy as the government can make it.
• As of yesterday’s conference, they said that there are currently 130 certified EHR complete programs and modules.  There are also five certification bodies now approved to test and give that EHR certifications, so the number of certified EHR programs and modules should continue to rise sharply over the next year.
• You can start in 2011 or 2012, work the program, and receive the maximum potential payout for the stimulus program (up to $44,000 over the five years).

Logic

• Dr. David Blumenthal, National Coordinator for Health Information Technology, Office of the National Coordinator for Health Information Technology (ONC), said that HIT in health care “is the 21st century circulatory system for medicine”.  He also gave a couple of practical examples he had dealt with where a fully function EHR system could have saved a life and then where having one did save a life.
• Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services (HHS),  gave some examples of e-tech not unlike EHR that have become so integrated in our lives that we can’t imagine living without them: online banking, debit cards, and ATM cash machines just to name a few “Can you even imagine having to write checks for everything anymore?”.  She asked why something as important as our health records (our life) isn’t managed, used, and as accessible as our money.
• Donald Berwick, MD, Administrator, Centers for Medicare and Medicaid Services (CMS), HHS, answered the question: What does the ‘meaningful’ mean in ‘meaningful use’?  The answer was “meaningful for patients and people who help patients”.  He also said that there is no one solution for each office or area.  He said “all solutions will be local”, but all will yield the same promises:  “better health, better care, and lower costs”.
• Farzad Mostashari, MD, ScM, Deputy National Coordinator for Programs and Policy, ONC, says that the continuing mission of the ONC and the EHR/meaningful use implementation is to improve quality, safety, and efficiency.  He went through several example of how better information, being tracked, can lead to better information, better treatments, and better outcomes.  He believes that by documenting better, streamlining medical processes and communication, along with a pooling a greater breadth and depth of health care knowledge that the results will be new innovations in health care.

Sticks and Stripes

• Medicare has already stated that by 2015 a Medicare Eligible Professional who is not demonstrating Meaningful use “will be subject to payment adjustments in their Medicare schedule”. (Per CMS teleconference Aug 10, 2010)

• They had a discussion with some people from various states that seemed to probably be part of the “beacon programs” (those that have already received special stimulus money for programs they were going to institute to promote and get the entire HIT program rolling in their respective areas).  They were having them describe their programs for implementing HIT mandates (including EHR meaningful use in healthcare offices) the solutions were varied, but the more interesting parts were how things failed:  areas with no internet access (so limiting their connectivity even with an EHR), areas with internet but dealing with unusual problems like every time a car runs over the road covering the main internet wires, they lose internet signal, to not enough money in smaller offices, to not having a clue about how to choose an EHR or implement it into their practice.  Some of these are very real problems that you might face (and other unknowns) as you implement an EHR into your practice, but still have issues making it a “successful go”.

But it gets worse…. 

• The Medicare statement aside (I knew that would be coming, you probably did too), it was just a matter of time.  However the implementation plans for some states has taken a step into the totalitarian.  One state, Massachusetts, is so serious about helping their doctors implement EHR that they were mentioning that doctors will comply or lose their licensure by January 1st, 2015.  If they get away with this measure, you can believe that other states will follow.  The only reason I can see for playing this kind of hard ball at the state level is because they feel government funding is dependent upon their compliance.  I would imagine this to begin with Medicare and Medicaid money going to the state from the Federal government. 

It is hard to imagine a doctor losing his license because he doesn’t have his notes on a computer.  But then again, if the Federal government or states believe they can force everyone to have healthcare, I guess it’s not really a stretch to believe they can force physicians to have computers and to use them to play nicely with others.

So here it is, in a nutshell:  

• Yes, you will have to move into an EHR.  
• Yes, they want to pay you some money.  
• Yes, there are many good reasons to do it.  

And

• Yes, you will pay for it now or later (and later might hurt a lot).

The opinions and views expressed in this article are solely those of me, Penny Henriksen, based on my best observation and notes from the conference.  If you want to know more please go to the sources as described at the top of this article and watch and listen for yourselves.