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Chiropractors need to speak up. States are considering additional incentives for EHR adoption.
-Greg
www.redpineservices.com
Interesting state development... the bill has as much crossed out wording than actual paragraphs. How they will be able to force HMOs and PPOs into giving out reimbursements to providers has yet to be determined. Since I can't afford to "significantly use" a c-EHR at a cost of some $60000 a year (see my calculations here), these bills, even if moved over to my state of Virginia, won't apply to me.
The most interesting thing is that Massachusetts, which we can all agree is probably the most digitalized state in the USA, even with all of its expenditures, with its control of the insurance market tilted towards HIT, even with positive spin papers such as seen here- http://www.healthdatamanagement.com/news/CPOE-27882-1.html?ET=healthdatamanagement:e802:46151a:&st=email&channel=business_intelligence, the one thing that caught my eye was that in that state, only 5% of physicians "meaningfully use" EMR, which is a measly 1% more than the national average. For all the vendors of c-EHR systems: don't count on gold dropping from the sky just yet. This politically correct tsunami of bills may, and probably will simmer down once the reality of a lack of physician interest begins to become a reality.
Al
Al Borges, M.D.
alborg: Interesting state development... the bill has as much crossed out wording than actual paragraphs. How they will be able to force HMOs and PPOs into giving out reimbursements to providers has yet to be determined. Since I can't afford to "significantly use" a c-EHR at a cost of some $60000 a year (see my calculations here), these bills, even if moved over to my state of Virginia, won't apply to me. The most interesting thing is that Massachusetts, which we can all agree is probably the most digitalized state in the USA, even with all of its expenditures, with its control of the insurance market tilted towards HIT, even with positive spin papers such as seen here- http://www.healthdatamanagement.com/news/CPOE-27882-1.html?ET=healthdatamanagement:e802:46151a:&st=email&channel=business_intelligence, the one thing that caught my eye was that in that state, only 5% of physicians "meaningfully use" EMR, which is a measly 1% more than the national average. For all the vendors of c-EHR systems: don't count on gold dropping from the sky just yet. This politically correct tsunami of bills may, and probably will simmer down once the reality of a lack of physician interest begins to become a reality. Al
Do you understand that with this mentality, we will never progress our country?
I say the exact opposite of Al on this one; if you want to see these stimulus programs materialize, step up to the batter box and help the progression of widespread EHR adoption. This is the only way we can take our healthcare system into the 21st century! How can you say that the lack of participation will make these programs simmer down?
They WILL pay you 75% of your Medicare allowed billables. So don't wait and don't avoid change because you are scared. The best advancements in the histor of mankind have come DIRECTLY from change. The HITECH Act will prove that we are willing to jump up to a more technological era, and as soon as the doc across the hall from you gets his check for $18k, I guarantee you will be purchasing and showing meaningful use of a certified EHR the next day. You can mark my words on this.
The only way to have this legislation die is to keep thinking like Al. Not that he's wrong, or that I'm trying to argue, it's just a fundamental difference in philosophies and understandings. But I can tell you this, I'm not willing to sit on the sideline while pessimism keeps us from progressing into a more efficient nation.
If you want to wait to see if things simmer down, that's great. But again, I guarantee you won't be waiting long as soon as your neighbor gets their first check!
Good points Al, this should be a good discussion for all.
Cheers!
Just found this, thought I'd share:
Survey Says: Americans Want EHRs
A recent consumer survey conducted by National Public Radio found:
Consumers are demanding EHRs. Billions of financial incentives are available. But implementing a comprehensive EHR takes time, and incentive qualification deadlines are looming. So join us at the Summit, where you’ll gain practical advice on how to adopt EHRs in a hurry. Here’s a summary of one key session:
Developing a "Big Bang" Timeline
While many hospitals have some of the components of a qualifying electronic health record in place, many lack certain functions required to earn incentive payments, such as CPOE or clinical decision support. How can hospitals add those functions in time to qualify for maximum incentives? This panel will provide practical insights. Featured speakers: Susan Heichert, CIO; Allina Hospitals and Clinics, and Bill McQuaid, CIO, Parkview Adventist Medical Center.
Again, don't just sit back and do nothing!
Actually, it's more than a fundamental difference in philosophies and understandings. Al's opinion is the product of years of skepticism, the kind that halts progression altogether.
Don't get caught up in what other, seasoned and seized, people tell you. If you want to live in a better country, with better healthcare and a better mentality towards progression, the choice is simple.
Be proactive and you will reap all the benefits of this great nation and what we can become in the VERY near future!
Greg:
>>> Three out of four Americans think it's important that their health care provider use electronic health records. 67% of Americans think it's likely that electronic records would improve the overall quality of U.S. medical care. 62% say the automated records would improve the quality of care their family.
That study was pushed by HIMSS, the vendor lobbying group, and it's biased premise brings forth results which mean nothing. Here are the problems with the study:
1) Most patients that I see don't use a computer let alone know what a certified EHR (c-EHR) is.2) Who the hell cares what a group of patients think about EMR and quality, all of whom can be influenced by lobbying efforts by those in the industry who stand to make money from physicians purchasing of c-EHR systems. What we want to see are real studies that show real useful data. We need prospective, large group studies that compare c-EHR to say, non-certified EMR (or paper) and ask both groups to follow certain P4P medical parameters. This has been done, and in at least 2 studies have shown NO increase in quality measures. If you are going to ask a small portion of people (doctors) to spend millions of their hard-earned money into an unproven c-EHR concept, then you need to do better than to post this "study", Greg!
Now, I can point to studies that show that EMR can bring forth 22 new errors, how c-EHR has been associated with poor outcomes and even increased deaths of children, how c-EHR has resulted in physicians being able to see less patients, making less money, and working more with increased frustration. I can point to c-EHR installations resulting in 50% failure rates, 8% deinstallation rates, and of those that make it, only 10% actually using their systems in a "significant manner". I can point to doctors that systematically upcode most of their visits, as recommended in the HIMSS website just to make some sort of ROI on their c-EHR.
I use a hybrid system, with the EMR made from scratch using MS Access. My patients love my EMR even though it's not "certified" as all of my letters and information sheets (s.a. medications) are in both Spanish and in English. I'm sure, though, that most of them would see me with or without my EMR- they want to get MY opinion, as a Board certified physician, not an opinion from a "smart" c-EHR.
>>> Al's opinion is the product of years of skepticism, the kind that halts progression altogether.
I am proactive, and in fact, I'm all for EMR, otherwise since 2004:
The difference between your phylosophy and mine is that you are trying to sell a c-EHR and I'm thwarting your ability to make the sale! I see the ligitimization of the CCHIT process as a scam that has been brought forth by the most heavy lobbying that I've ever seen in my life by the vendor organization, HIMSS. Even after massive expendatures and governmental investment in the certification process, the concept of the c-EHR has been a failure, with only 4% of physicians and less than 2% of hospitals significantly using c-EHR. Now corrupt politicians are making arcane laws that they hope can can either entice or even force doctors into buying the c-EHR wares. This will make the practice of medicine costlier and worse yet, will banrupt many doctors and force them out of business.
The only weapon that I have against this intrusion of forced c-EHR is the internet where I can post real studies, data, and calculations that allow those doctors that aren't EMR saavy to become instant "informed consumers". I am the voice of reason that will prevent them from making the mistake of buying an expensive EMR. Knowledge is everything...
PS: My attitude about those docs that ignore me and try to go HITECH-
I appreciate your well informed research Al. These conversations are creating dialogue on both sides of the issue, it's a good thing. Progressing this industry is key.
Please don't think you are thwarting my efforts to conrtinually serve the Chiropractic community. No matter what you say, do or feel, the fact remains that EHR systems provide the tools practitioners need.
As a new generation begins taking their seat to run this world, you can be assured that their ways of thinking will take over also. Ignoring the future has proved fatal for most, but if you are willing to accept change and grow from it, the future presents your biggest opportunity yet Al.
Growth is knocking on our doors and we aren't passing up the opportunity!