But complications, costs, frustrations cited
WASHINGTON – Just three days past the Jan. 6 opening day for providers to register for meaningful use incentives, the Centers for Medicare and Medicaid Services announced that some 4,000 healthcare providers had signed up.
"We expect that number will continue to increase daily," said CMS spokesman Joseph Kuchler at the time.
Yet the numbers didn't tell the whole story. At a hearing held Jan. 10-11 by the Health IT Standards Committee Implementation Workgroup in Washington, providers seeking incentives shared experiences on their struggles to attain meaningful use.
Lyle Berkowitz, MD, a practicing internal medicine physician and the medical director of clinical information for the Northwestern Memorial Physicians Group, the largest primary care group in Chicago, said his group has been using electronic medical records since 2003.
The group is lucky to have resources and seven years of experience using EHRs, Berkowitz said, but the organization is only 20 percent ready to qualify for incentives under the meaningful use program.
"There has been concern about introducing too many new functions and workflows into a highly complex system," he told the workgroup.
"It's a zero sum game," Berkowitz said. "Putting resources to work on meaningful use requires taking some away from other projects."
Malpractice insurance is a factor, he said, as rates have risen because of meaningful use. The group has also had to add costly new functions to their system, but is frustrated by not knowing how long it will take to get the system to work properly for meaningful use and not knowing when their workflows will be smoothed out, Berkowitz said.
Scott Hammer, MD, from the Southern Delaware Medical Group, said his four-physician practice has been using EHRs for years and doing it meaningfully.
Despite his practice's dedication to EHRs, he said he has begun to wonder, "Are meaningful use dollars meant for medical practices at all?" More and more time and resources are required to prove meaningful use, he said. With add-on vendor fees, portal company fees and payments to tech support contractors, it would take the physicians in his practice working roughly two more weeks a year to pay for it.
He warned the workgroup: "You need to make sure incentives are enough for small practices that teeter on the fence.”
Meeting all requirements necessary to demonstrate meaningful use of electronic health records will be challenging for many hospitals, said Joanne Sunquist, CIO at 440-bed Hennepin County Medical Center, a safety net teaching hospital in Minneapolis. "Creating the reports for eligible hospital MU objectives and quality measures has become an onerous, difficult and time-consuming process.”
Charles Christian, CIO of 232-bed Good Samaritan Hospital in rural southwest Indiana, told the panel his organization was fortunate to get a head start on implementing technology.
"GSH was early to realize the importance of the appropriate implementation of technology in the effective and safe provision of care," Christian said in January. The hospital and medical staff worked together to identify applications "that would improve the care process and create a safer environment in which to deliver high-quality care."
