Ambitious 5-Year Timetable For Electronic Medical Records

RICARDO ALONSO-ZALDIVAR   07/13/10 05:16 PM ET   AP

Medical Records

WASHINGTON — The Obama administration on Tuesday rolled out an ambitious five-year plan for moving doctors and hospitals to computerized medical records, promising greater safety for patients and lower costs.

Starting next year, doctors' offices and hospitals can get federal money to help defray the costs of the systems, which can run to millions of dollars for hospitals. Providers who don't comply by 2015 will face cuts in Medicare payments.

Federal incentive payments for doctors and hospitals to buy computerized systems could reach $27 billion over 10 years, and that's only a fraction of what technology vendors stand to take in. It's hoped the investment will streamline the delivery of medical care, yielding long-run savings.

Patients get the benefit of systems that can warn doctors before they make a mistake – prescribing a drug that could cause a severe reaction, for example. And there's also the convenience of being able to access records online.

The move by the Health and Human Services Department came with the release of two regulations hundreds of pages long. The main one described how doctors and hospitals can qualify for federal money by acquiring systems that meet certain "meaningful use" standards. A companion rule outlined how the systems will be certified.

Initial reaction from key interest groups was guarded. As lawyers pored over the text of the regulations, the American Medical Association said it was withholding judgment. The American Hospital Association said it is concerned about serveral aspects.

Federal officials said they tried to address doctors' complaints that the initial draft of the rule asked them to do too much, too quickly. More than half of family doctors practice in groups of four or fewer. A majority of small and medium offices have opted not to adopt electronic records because of costs and unresolved questions, according to the American Academy of Family Physicians.

David Kibbe, an adviser to the group, said that may start to change. "This is pretty good news," he said. "It will almost certainly translate into more physicians becoming participants in the electronic health records incentive program."

Money for electronic records was included in the 2009 economic stimulus bill.

Administration officials said they lowered the number of initial, "core" capabilities that the systems have to demonstrate in order for providers to get federal money, and allowed a longer period of time to achieve others.

They also lowered several additional requirements. Only 40 percent of medications will have to be electronically prescribed, as opposed to 75 percent as the government initially proposed.

The result "strikes the balance that was needed," said Steven Findlay, a policy expert with Consumers Union. "They give doctors the financial support to promote electronic records adoption without undue burdens. But they also hold doctors accountable for actually improving care and the health status of their patients."

The top government official overseeing the transition program says that reflects what happened to him in a previous stage of his career, when as a middle-age primary care doctor he was forced to learn to use electronic medical records.

David Blumenthal, now national coordinator for electronic health records, said the computer once saved him from prescribing a drug to a patient who was allergic to the medication. On many other occasions, he was able to avoid ordering duplicative tests, because earlier results stored in the system told him what he needed to know.

"I watched it make my care better before my eyes," said Blumenthal, formerly a prominent Boston area physician and Harvard professor.

Doctors' offices can receive as much as $44,000 through Medicare and $63,750 through Medicaid for installing computer systems that meet federal standards. Hospitals can receive millions.

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Online: http://www.hhs.gov

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WASHINGTON — The Obama administration on Tuesday rolled out an ambitious five-year plan for moving doctors and hospitals to computerized medical records, promising greater safety for patients an...
WASHINGTON — The Obama administration on Tuesday rolled out an ambitious five-year plan for moving doctors and hospitals to computerized medical records, promising greater safety for patients an...
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HUFFPOST SUPER USER
Tom95134
01:06 PM on 07/14/2010
It's relatively easy to "convert" to a digital medical records system. The major expense comes from transcribing all those history records into the system and then verifying that the transcription happened correctly.

In many businesses transcription of records from paper to digital was done off-shore by companies located in English speaking countries. The technique was to have two or three people transcribing the same record and then a comparison was done to detect transcription errors. Dealing with typical business documents was fairly easy but transcription of medical records will be much more difficult because of the highly technical nature of the information and the mixture of English and Latin terminology. IMO, the target data is not realistic.
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Equinator
Shovels manure daily
12:15 PM on 07/14/2010
Once you go digital, you will wonder how you ever got along with out it.
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HUFFPOST COMMUNITY MODERATOR
benji85
08:36 AM on 07/14/2010
Yes the upfront cost to go digital is expensive, but think about the long run. You don't have cabinets full of paper that will almost never be looked again. There wont be a need to keep a second storage area for old patient histories. Plus finding previous diagnosis, and prescriptions, would be as simple as typing the patient's name, assuming everything has been put in their history.
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HUFFPOST SUPER USER
Tom95134
01:12 PM on 07/14/2010
What you will need to do is to make sure that when you move these records from one electronic storage medium to another is that the conversion happens error free. In addition, migration to new storage media and devices needs to be budgeted for because technology changes and once you go electronic you need to keep ahead of equipment obsolescence. Try to find a place where you can play a television video tape made in the early 1960s. To date, the most stable storage medium for images is properly stored black&white film.

There is no free lunch.
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HUFFPOST COMMUNITY MODERATOR
benji85
07:08 PM on 07/14/2010
Two media formats that have stuck around since the coming of personal computing, has been tape, and hard disk storage.
02:14 PM on 07/14/2010
I have been quoted 70,000 for PART of my files just to convert them to digital. Then there is hardware and software and maintance cost. Do you really think it will pay for itself?

I have gone electronic in all my other area's of the business. and yes I LOVE it ...but come on we are in the last 10 years of our career's and I will do it IF they can tell me WHAT "meaningful use" mean's and what qualifies "meaningful use" .

This is very feasable for a Physician starting out in practice, however those who have been in practice 20+ years that have ton's of charts to convert...It really is not.
08:06 PM on 07/13/2010
Yes ...of course they can ...LOL except they still haven't defined "meaningful use" and WHO decides who implemented a "meaningful use" EHR ?
It will cost at LEAST 100,000/ provider... AND what about Data Breaches? Blue Cross, Atnea, and Kaiser have had security breaches. A breach can cost 50,000/patient...This is NOT an option for the smaller provider offices, a breach could bankrupt them.
Smaller doctor practices are screwed...retirement here we come !!!
KennebunkportIndependent
Back in my day, we had NINE planets.
05:55 PM on 07/13/2010
Because I own a business in the UK, I contribute to the NHS. On a recent trip, I had a recurrence of a condition that required a hospital visit. Phoned NHS Direct, discussed the symptons with a nurse; was told to go to nearest hospital casualty. I arrived and was seen by a doctor within two minutes who had my complete medical history electronically saved on the computer. Why is the US system claimed to be better?

The cost of this episode - I don't know. I will never see a bill.
08:15 PM on 07/13/2010
I agree with you completely... It is a HORRIBLE medical system. The AMA stopped representing Physicians along time ago. They represent "physician groups" which a lot of times are not even owned by Physicians. Funny thing "Physician Groups" or IPA's are just an unregulated way the BIG insurer can DENY care.
Think about it...If you have more than one company adminstering your healthcare you have TWICE (sometime 3X) the cost of adminstration.
Our only hope is SINGLE payer