All About Electronic Health Records

The Health Information Technology for Economic and Clinical Health (HITECH Act), which was passed as part of the American Recovery and Reinvestment Act of 2009, has fostered significant progress in the adoption of Electronic Health Records (EHRs) in various clinical settings, particularly through the Medicare and Medicaid EHR Incentive Programs and its focus on EHR adoption in Stage 1 Meaningful Use (CITATION gov). For instance, as a result of the Medicare and Medicaid EHR Incentive Programs, the percentage of office based physicians who have adopted an EHR system dramatically rose from 18.2% in 2001 to a staggering 78.4% in 2013 (CITATION phys data). Additionally, as of July 2013, 67% of hospitals achieved Stage 1 Meaningful Use and an additional 16% were paid for adopting EHRs (CITATION hosp data).

However, despite the $24 billion of federal spending allocated towards EHR adoption, the benefits of EHR adoption still have not been even close to fully realized (CITATION 24 b). Specifically, duplicate and unnecessary medical testing, which EHRs were set out to address, still presents a significant financial burden and, more importantly, less efficient and effective patient care from a lack of care coordination and provider communication (CITATION issue brief). In fact, a recent Boston study found that 20% of the patients transferred between hospitals underwent duplicate, unnecessary medical tests that were performed within the last 12 hours (CITATION boston).

These issues manifest themselves in two ways. First, the criteria set out for Stage 1 Meaningful Use overlooked EHR vendors' lack of incentives or requirements to design their EHR systems in such a way that makes them able to easily transfer patient data to other providers ...

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...ck of EHR interoperability, there are inevitably several challenges that must be considered in order to ensure that these solutions are successfully carried out.

Medicare and Medicaid Incentive Programs – Stage 2 Meaningful Use

Although most physicians may be prepared to attest to Stage 2 Meaningful Use, several of the stakeholders that they interact with may not, which may compromise their ability to fulfill all of the Stage 2 Meaningful Use criteria and lead to Medicare reimbursement penalties as a result of factors that they have no control over. For instance, there are currently no federal incentives home health agencies or skilled nursing facilities to adopt EHRs, which presents a foregone opportunity for physicians to complete electronic summary of care documents when they perform transitions of care or referrals to these care settings (CITE narsin' homezzz).