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GOP lawmakers question health record system incentives

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The U.S. Department of Health and Human Services (HHS) should make sure that the new electronic health record (EHR) incentive program promotes use of EHR systems that work well together.

A group of Republican House members that includes House Ways and Means Chairman Dave Camp, R-Mich., and House Energy and Commerce Chairman Fred Upton, R-Mich., gave that recommendations in a letter they sent earlier this month to HHS Secretary Kathleen Sebelius.

“It is highly counterproductive for providers to have purchased EHR systems that cannot ‘talk with one another,’” the lawmakers said in the EHR letter, which was posted on the Ways and Means Committee website.

HHS also should make other EHR incentive program standards tougher, the lawmakers said.

Today, the lawmakers said, HHS simply requires that an EHR summary follow a patient who moves to a new care setting just 10 percent of the time.

HHS also is requiring that radiology and laboratory orders be electronic just 30 percent of the time, the lawmakers said.

That requirement “is woefully inadequate,” the lawmakers said.

The lawmakers were reacting to an EHR survey report released by the Bipartisan Policy Center, a think tank set up by former Senate majority leaders Howard Baker, Tom Daschle, Bob Dole and George Mitchell.

Health policy specialists have been arguing for years that the U.S. health care system could work better if doctors, hospitals, insurers, patients and others could share patient health and health insurance information through convenient, reliable data networks.

Members of Congress included funding for a formal EHR adoption incentive program in the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009.

The EHR incentive program is supposed to encourage doctors and hospitals that treat Medicare patients to shift to EHR systems by paying bonuses to providers that show they are moving toward “meaningful use” of the systems.

Program backers argue that the incentives could help commercial health insurers as well as government plans, because most of the providers that treat Medicare patients also treat commercial plan patients.

The Bipartisan Policy Center analysts based their EHR system report on survey responses from 725 health care providers.

The analysts note in the report that the responses did not come from a random sample of providers, and that the survey participants appeared to be more interested in EHR systems than typical providers.

About 75 percent of the survey participants are using EHR systems. The government’s National Center for Health Statistics has found that only about 55 percent of all providers are using EHR systems, the analysts said.

The analysts found that the typical physician who participated in the survey is trying to coordinate patient care with an average of 229 other physicians.

The Centers for Medicare & Medicaid Services (CMS) has started applying the first, “Stage 1″ standards and is in the process of completing “Stage 2″ standards.

About 15 percent of the eligible health care professionals and 82 percent of the eligible hospitals had signed up for the incentive program as of August, according to provider count data from the U.S. Government Accountability Office and registration data from CMS.

The Bipartisan Policy Center survey participants said they have high hopes for how the electronic exchange of information eventually will affect the health care system.

About 80 percent predicted electronic health information exchange will improve the quality of care, 80 percent predicted it will improve providers’ ability to coordinate care, and 57 percent predicted it will cut health care costs.

Today, the providers said, the main barriers are the cost of setting up and maintaining information exchange systems, lack of information about how to use health information exchange systems, and the inability for the providers’ own EHR systems to communicate with other EHR systems.

Seventy-one percent of the survey participants said “lack of EHR interoperability” is a major barrier to sharing patient data with other providers electronically. 

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