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Health Care
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Hospitals And Health Systems

Health Care Reform

Making Meaningful Use of Health Information Technology
======================================================

by Dan Peterson April 10, 2010 11:02 AM (PT) Topics: Hospitals And
Health Systems, Medicare And Medicaid

 

 

4679 Views

Health Information Technology (HIT), one of the rare concepts in
Washington to still enjoy bipartisan support, has been a hot topic
this month with several significant updates. But wait, before you
reach for the mouse thinking this is just some geek news, realize that
what happens in the HIT world has a major impact on many of the
mainstream health care topics including quality outcomes and cost of
care.

First, the Department of Health and Human Services announced this week
awards of $267 million to 28 non-profit organizations to establish
Health Information Technology Regional Extension Centers. The money is
part of the sizable health care commitment in the American Recovery
and Reinvestment Act and will support the much needed growth in HIT
workers as well as provide technical assistance to physician offices
trying to implement electronic medical records.

The Extension Centers are just a piece of the puzzle in the Recovery
Act's extensive plan to insert HIT into physicians' offices and
hospitals across the country. Also part of the stimulus fund is the
HITECH program that provides incentives to providers to use electronic
medical records. Private physicians can receive up to $44,000 over
five years in increased Medicare or Medicaid payments by using
certified HIT. The catch is that they can't just buy an EMR system and
get the money. Rather, physicians need to make "meaningful use" of the
technology. That phrase has caused considerable concern in the
industry.

The Centers for Medicare and Medicaid Services (CMS) has been getting
considerable input from both health care providers and now Congress on
the proposed rule and definition of meaningful use. In the last two
weeks, a bipartisan group of 64 Senators and 249 Representatives have
written to both HHS and CMS to ask for less stringent requirements for
providers to receive the HITECH incentives. Specifically, there is
objection to the "all-or-nothing" approach of meeting all meaningful
use requirements or receiving no money at all.

Will all of this technology in your doctor's office do any good? Will
we actually see better quality care and/or lower costs? It depends on
who you ask. Two new studies, appearing this week in Health Affairs
(which devotes its entire April issue to HIT), report mixed results.

Researchers from the Institute for Health Policy at Massachusetts
General Hospital were not able to find any significant relationship
between a broad range of U.S. hospitals that had implemented
electronic health record technology and improvements in care quality
or cost efficiency. Specifically, better outcomes in acute myocardial
infarction, congestive heart failure or pneumonia were not present at
these EHR-based hospitals while there was also no reduction in
risk-adjusted length of stay.

This result makes a good argument for the meaningful use requirement.
These hospitals may have installed the systems, but clinicians may not
have been trained properly on not only how the software works but also
how to use it effectively.

On the other hand, the federal Veterans Administration has been using
HIT for over twenty years. Researchers from the Center for IT
Leadership at Partners Healthcare in Massachusetts found that the
long-term payback has been substantial. According to the authors, "We
conservatively estimate that the VA's investments in the four health
IT systems studied yielded $3.09 billion in cumulative benefits net of
investment costs by 2007."

Specifically, the savings came from avoiding hospital admissions,
making better use of square footage by reducing paper charts, easing
workloads of providers and reducing unnecessary or duplicate medical
tests.

With the HITECH funding starting in 2011, plan on plenty of continued
dialogue on this topic. However, the age of EMRs and HIT is here to
stay. If you want a second opinion, just ask your doctor.

Photo credit: southerntabitha

Qicrqebudyqbzim-30x30-cropped

Dan Peterson is part of the management team at a regional health care
system focusing on the intersection of patients/providers, HIT,
clinical operations and government reform. He blogs at Sports Are 80
Percent Mental.

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Kxtmolbzhnfgrsk-110x80-cropped Previous Story: Do Pleasant Residencies
Produce Good Doctors? Vzlaljpyyqbhpnp-110x80-cropped Next Story: Know
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