Special report: The confusing, promising world of EMR/EHR

Rapport spécial : Confondre, monde prometteur d'EMR/HER

par Diana Bradley, Staff Writer | February 21, 2012
From the January/February issue of HealthCare Business News magazine


But more and more physicians are catching on and EHR adoption is on the rise. Between 2001 and 2011, office-based physicians’ adoption of electronic health records rose from 18 to 57 percent, doubling over the past three years, with one in three currently using a basic system, according to the Centers for Disease Control and Prevention. By 2016, the utilization of EHR systems will swell to over 80 percent, anticipates research firm IDC Health Insights in its November report entitled, “IDC MarketScape: U.S. Ambulatory EMR/EHR for Midsize and Large Practices 2011 Vendor Assessment.”

Regulations and incentives
Massive fees usually accompany the transition from paper to digital medical records, with the average EHR implementation ranging from $2 to $16 million, according to a December Kaiser Health News report. Primarily responsible for EHR’s booming presence is the 2009 federal economic stimulus package – under which, health care providers who digitize and have a decent-sized pool of Medicare or Medicaid patients can qualify for health information technology granting economic and clinical health incentive payments totaling up to $27 billion over 10 years, or as much as $44,000 per clinician through Medicare and $63,750 per physician through Medicaid. This incentive is called “meaningful use” and covers the costs associated with going digital and bringing staff up-to-speed.

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The three main components of meaningful use, as defined by the American Recovery and Reinvestment Act of 2009, are: the use of a certified EHR in a meaningful manner, such as e-prescribing; the use of certified EHR technology for electronic exchange of health information to improve health care quality; and the use of certified EHR technology to submit clinical quality and other measures. Over the next five years, the criteria for meaningful use will be staged in three steps: Stage 1 (2011 and 2012) sets the baseline for information sharing and electronic data capture; Stage 2 (2013) and Stage 3 (2015) will be developed through future rulemaking and continue to expand on this baseline.

Medicare incentives for demonstrating meaningful use of EHRs have amounted to $920.3 million, while Medicaid payments for providers to adopt, implement and upgrade their EHRs reached an estimated $916 million for a total of $1.8 billion, according to the Centers for Medicare and Medicaid Services December 2011 EHR Incentive Program report. As of December, CMS had paid incentives to 10,566 Medicare providers and 12,070 Medicaid providers, with 769 hospitals attesting successfully. Of the 21,308 physicians who had verified their meaningful use demonstration, 444 were unsuccessful, failing to meet the required threshold for one or more objectives. 52 percent of physicians reported they are planning to apply for the meaningful use incentives, up from 41 percent in 2010, according to a November National Center for Health Statistics data brief. CMS anticipates that more physicians will get on board the closer it gets to Feb. 29, as they can attest for 2011 payments up to that date.

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