NASS Education Session Examines Pros and Cons of EHR Adoption

Electronic health records, or EHRs, are increasingly becoming the norm in doctor’s offices and hospitals around the United States. This May, the U.S. Department of Health and Human Services (HHS) announced it has met and exceeded its goal for 50 percent of doctor’s offices and 80 percent of eligible hospitals to have EHRs by the end of 2013.

“We have reached a tipping point in adoption of electronic health records,” said HHS Secretary Kathleen Sebelius. “More than half of eligible professionals and 80 percent of eligible hospitals have adopted these systems, which are critical to modernizing our health care system. Health IT helps providers better coordinate care, which can improve patients’ health and save money at the same time.”

The Health Insurance Portability and Accountability Act of 1996 contains a provision known as the Administrative Simplification provision, which requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. Government agencies such as Medicare and Medicaid offer incentive programs to medical professionals, eligible hospitals and critical access hospitals as they adopt, implement, upgrade or demonstrate “meaningful use” of certified EHR technology.

As defined by HealthIT.gov, a U.S. government-run website that provides information on health information technology (IT) to consumers and providers, meaningful use means keeping complete and accurate information; providing better access to information; and providing patient empowerment.

During a special education session held at this year’s annual meeting of the North American Spine Society (NASS) held in New Orleans, James Frederick Harrington, M.D., a neurosurgeon at the University of New Mexico Center for Spinal Health in Albuquerque, explained the advantages and disadvantages to spine surgeons of adopting EHRs.

“The push for meaningful use created an artificial market for immature EHR products,” said Harrington. “Many physicians who adopted EHRs with the intent to apply for meaningful use incentive payments may have rushed to decision they now regret.”

The rush to adopt EHRs with the hope for incentives payments is understandable. Harrington, who escaped the pressure to implement EHRs when he returned to academia from a short stint in private practice, explained that on average, a physician will spend $54,000 on an EHR and $10,000 on annual maintenance—which, as Harrington pointed out, is “a big financial investment for small or solo practices.” And according to the Medicare/Medicaid website, “eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.”

But implementing a system prematurely can lead to myriad problems that can hinder rather than aid a practice. According to Harrington, it is vital that a physician assesses the readiness of their practice and make sure their staff is ready for EHR implementation. Harrington encouraged physicians to clearly define how an EHR will change their practice for patients, providers and staff. Clinical, revenue and work environment goals should be set.

“There was a rush to EHR business over the last several years,” Harrington warned. “Check to make sure your EHR vendor is certified by the office of the National Coordinator for Health Information Technology.”

Harrington stressed the importance of working with a vendor that provides satisfactory training and follow up support in the event of necessary upgrades or system failures. In August this year, the family of physician practices and hospitals Sutter Health in Northern California experienced a complete failure of its $1 billion Epic EHR system. On Aug. 26, nurses, physicians and hospital staff totally lost access to patient information, including what medications patients were taking and all vital patient history data. According to reports, some registered nurses blamed the hospital system for not providing adequate support during the blackout—but according to Harrington, the more important issue is to preempt such accusations by making sure you work with an EHR vendor that will provide such support when needed.