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Tech Firms Eager to See Health Record Criteria

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The Office of the National Coordinator for Health Information Technology (ONC) is getting ready to unveil standards that could help lead to increased physician use of electronic health records.

The ONC is polishing the first set of criteria that health care providers will be using to show whether they are making “meaningful use” of electronic health record (EHR) systems, and new criteria could come out sometime in the next 10 days, according to Jordan Battani, a principal at CSC Global Healthcare Group, a unit of Computer Sciences Corp., Falls Church, Va.

The EHR meaningful use provision is part of the the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009, which, in turn is part of the American Recovery and Reinvestment Act of 2009. The EHR provision authorizes Medicare and Medicaid to distribute $18 billion in incentive payments to physicians and hospitals that are meaningful users of EHR systems. The incentive program is supposed to start in 2011.

Generally speaking, “meaningful use” means using EHRs in a way that supports clinical decision making, Battani says.

Some skeptics question whether EHR systems will do much to hold down health care spending, but advocates say the systems will improve the quality, safety and efficiency of care and may reduce costs.

Although health care providers will get incentives for meeting EHR milestone tests, providers who are still not using EHR systems after 2015 will face penalties. If Medicare and Medicaid managers enforce the requirements now set to take effect in 2015, providers who are not using EHR systems may not receive Medicare or Medicaid reimbursement, Battani says.

The Blue Cross and Blue Shield Association, Chicago, says it supports nationwide adoption of health information technology, including EHRs, but is concerned that the HITECH Act overlooks the contributions that health plans, such as the Blues, can make to promoting EHR adoption.

Health plans already have established the infrastructure for exchanging clinical data, administrative data, and clinically meaningful claims data, the association says.

“Until we reach a point where the majority of physicians are using EHRs and all EHRs are using uniform approaches, the best source of electronic data is claims data,” says Joel Slackman, managing director of the association. Only claims records contain information about the cost of care, he says.

The Centers for Medicare and Medicaid Services has proposed that providers should have to meet all objectives to receive incentive payments, and that “all or nothing” approach could backfire, Slackman says.

“If a physician is already using a Web portal to send claims electronically, they should be given credit for that,” Slackman says.


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