Reaping the Benefits of Health IT
By Ray Valek
In partnership with
Health information technology is contributing to better healthcare quality. But because many providers remain on the sidelines, there’s huge potential in the marketplace.
It’s payback time for many healthcare providers, in a positive way. Nearly $400 million of incentive payments have been made so far to hospitals, physicians’ groups and other providers meeting Stage 1 “meaningful use” requirements for electronic health records (EHRs), the Centers for Medicare and Medicaid Services announced in August.
The payments began in January, nearly two years after the passing of the HITECH Act of 2009. The act established an incentives program rewarding providers that implement EHR systems and demonstrate their use toward improving patient care quality. Several medical studies have linked EHRs and other kinds of health information technology (IT) to measures of healthcare quality, such as reduced medication errors, better clinical outcomes or decreased hospitalizations or mortality. Studies also link health IT to reduced costs.
While $400 million in incentives represents a “good start,” there is still a “huge upside” for EHR implementation, says H. Stephen Lieber, CAE, president and CEO of HIMSS (Healthcare Information and Management Systems Society). “We’re approaching the halfway mark with hospitals, but we’re a long way from it on the physicians’ side,” he states. About 75,000 eligible practitioners are now participating in the incentives program out of a total number “that’s literally in the hundreds of thousands.”
According to Lieber, many medical practices are uncertain about whether current EHR products will enable them to meet Stage 2 and 3 meaningful use criteria, which are still being developed. To earn incentive payments at these later stages, providers will need to demonstrate meaningful use to a greater extent, he explains. For example, in Stage 1, a provider must submit at least one medication order electronically for 30% of all patients requiring prescriptions; in Stage 2, the requirement may increase to 60%. New requirements, such as the capability to send secure electronic notes to patients, may be added.
Athenahealth’s Cloud-Based Solutions Lessen Burden on Providers
Athenahealth’s “purely cloud-based” EHR, practice management and billing services require no capital investment in hardware or an IT staff, says Dr. Todd Rothenhaus, athenahealth vice president and chief medical information officer. Through athenaNet®, clients receive web-based software connected to a proprietary database that is continually updated as government regulations and incentive programs, insurance rules and clinical guidelines change.
All clients automatically benefit from these frequent updates, without having to worry about implementing them. For example, “If we realize an insurance company is asking for an additional piece of information or they kick out a claim, we build that right into athenaNet and every customer immediately benefits, thereby reducing the number of rejected claims all of our clients would receive,” Rothenhaus says.
The ability to make these quick, network-wide updates will enable athenahealth to be one of the fastest companies to market products and services meeting Stage 2 meaningful use criteria, Rothenhaus predicts. He says Stage 2 criteria are likely to be finalized “right in the middle of conversion to ICD-10,” an update to the system of diagnostic codes used by providers for billing purposes. He anticipates many companies will charge their customers to install updates relating to Stage 2 and ICD-10, but “being web native allows athenahealth to do that seamlessly.”
For athenahealth, the bottom line is enabling all its clients to demonstrate meaningful use by the deadlines and earn their incentives. When the deadline for 2011 awards comes, Rothenhaus asks, “How many people are going to be over the hurdle? And in 2012, which is the last year for the full award, what’s that going to look like? To us, it’s about who gets the higher percentage of doctors over the line.”
CDW Healthcare Urges Providers to “Simplify and Accelerate” to Minimize Productivity Losses
CDW Healthcare surveyed 200 physician practices and found that the total cost of EHR implementation—both in outlays and lost revenues—was about $120,000 per physician in the first year. However, only about 12% of these costs were associated with hardware and software. “Most of the costs were around lost productivity,” says Bob Rossi, CDW Healthcare vice president.
After full implementation and adoption, an EHR added as much as $150,000 per physician in annual revenue due to increased efficiencies, the survey found. As a result, CDW Healthcare advises customers to “simplify and accelerate” when evaluating and implementing health IT. “Faster adoption overall will get them back to the prior level of productivity—and even accelerate past that,” Rossi explains.
CDW Healthcare works with providers of all sizes to develop health IT solutions that will meet their clinical objectives and assure secure IT infrastructure. Some of these providers have highly integrated and advanced IT systems, but Rossi agrees with Lieber that most providers are still working to achieve Stage 1 meaningful use criteria. Some providers are encumbered by internal complications that make implementing health IT a long, challenging process, he explains.
Sometimes it’s easier to start from scratch. For example, when physical therapist Justin Silver was planning to open ProFormance Physical Therapy in Skokie, Ill., he turned to CDW Healthcare for guidance before treating a single patient.
Silver envisioned a practice that used health IT to enhance patient care and thrive in a competitive marketplace. After receiving guidance from the CDW Healthcare, Silver decided to implement PowerWorks, a completely paperless EHR and practice management system provided by Cerner, one of many companies working in partnership with CDW Healthcare. The partners also teamed up to provide training and support to Silver and his staff. Today, “Our staff can provide better care to patients because documentation doesn’t take up so much of their time,” Silver says.
The Next Frontiers
As increasing numbers of providers implement health IT, they will gradually become networked online with patients, insurance companies, pharmacies and other care providers and partners, first locally, then regionally, nationally and even internationally. Lieber, Rothenhaus and Rossi agree this interoperability is where a significant payoff will come, both in healthcare quality and cost efficiency. This dynamic will eventually make secure health information, previously confined to a particular provider, available to providers anywhere in the world. “That’s where the real power is,” Rossi emphasizes.
In addition, Rothenhaus says, “There’s something missing in the way the healthcare system interacts with consumers, and that’s going to be the most fundamental change.” He says all providers must develop secure electronic messaging, telemedicine and other consumer engagement capabilities, and predicts that tremendous innovation will occur in “bringing and connecting the EHR to ecosystem partners that will emerge in the care-management and direct-to-consumer space.”
Lieber and Rossi point to dramatic improvements in mobile and wireless technologies, as well as clinical decision support applications, that bring the latest test results, guidelines and research to the point of care. Lieber says these innovations will enable providers to treat each patient according to documented evidence and individual characteristics, and will create “the opportunity to transform the practice of medicine.”
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