Tuesday, September 19, 2017

61% of healthcare officials indicate terrible, poor ROI on EHRs, survey finds



What did the HITECH ACT and Federal investment for electronic health records produce ?

The Rand Study Projected  benefits for EHRs  which failed to materialize. There are many reasons.

Enough time has passed to evaluate the impact of electronic health records on the practice of medicine in hospitals and outpatient facilties.
The results are damning. Despite early warnings by those in the trenches HHS, and CMS wantonly disbursed over 35 billion dollars into inadequate EHR systems. The systems were immature, untested, user unfriendly and made work loads for physicians and other health professionals so difficult that it initiated an enormous increase in physician burnout, early retirement and the death of private solo practice.  A term "meaningful use" was invented, not to make the systems more usable but to subvert the data accumulated to be 'scraped' and analyzed for later analysis.  MU also required EHRs to be interoperable (not a bad idea) as well as contain certain data fields many of which are not germane to specialty medical practice.  Unless this data was accessible to CMS physicians would be penalized a significant sum for non-compliance.
This was a windfall to hardware and software vendors,  and a new group of expensive consultants to advise health providers on IT.
The results are now in. 
Becker's Health IT and CIO Review reports:
Nineteen percent of healthcare professionals rated the return on investment for EHRs as "terrible," according to a Health Catalyst survey.
Health Catalyst surveyed more than 1,100 healthcare professionals about their attitudes toward EHRs at the Healthcare Analytics Summit in Salt Lake City earlier this month.
Here's how healthcare professionals responded when asked to assess the ROI produced by EHR investments since the Health Information Technology for Economic and Clinical Health Act of 2009, which incentivized EHR adoption.
1. Terrible: 19 percent
2. Poor: 42 percent
3. Mediocre: 29 percent
4. Positive: 9 percent
5. Superb: 1 percent
Nineteen percent of healthcare professionals rated the return on investment for EHRs as "terrible," according to a Health Catalyst survey.
Health Catalyst surveyed more than 1,100 healthcare professionals about their attitudes toward EHRs at the Healthcare Analytics Summit in Salt Lake City earlier this month.
Here's how healthcare professionals responded when asked to assess the ROI produced by EHR investments since the Health Information Technology for Economic and Clinical Health Act of 2009, which incentivized EHR adoption.
1. Terrible: 19 percent
2. Poor: 42 percent
3. Mediocre: 29 percent
4. Positive: 9 percent
5. Superb: 1 percent

Increasing Costs

In 2009, the Congressional Budget Office (CBO) estimated that fully integrated interoperability would save the Medicaid and Medicare programs $12.5 billion through 2019. These savings have yet to materialize and with 50 percent of doctors unable to meet current program requirements, it is unlikely that taxpayers will see these savings in the near future. Moreover, the number one complaint we hear from providers is the unexpected costs of maintaining and upgrading their systems.
ONC does not describe how it will determine the costs associated with the adoption of expanding interoperable platforms. Nor does ONC explain how it would evaluate cost or incorporate cost control into the development and scaling of interoperability. Provider concerns about the cost of complying with the program should be addressed in the roadmap.
We appreciate the notion that as new models of care begin to reward providers for outcomes, changing incentives will reward interoperability. We agree. However, we live in the aftermath of the HITECH Act, where to date $28 billion have not resulted in significant improvements to clinical care coordination or quality. Without concrete immediate and long-term steps, tied into accurate, usable (and collectable) performance measures, we will continue to see a meager return on investment.

Lack Of Oversight

One way to improve oversight of the program is to put in place measures to gauge success. ONC appears to be taking a step in the right direction by describing seven different lenses to measure and evaluate the quantity and quality of information flow within interoperable systems, such as who is exchanging information, and where and what type of information is being exchanged. However, without specific performance goals for each type of measurement, it is unclear how ONC will measure success. In addition to defining these metrics, effective oversight includes describing how the metrics will be collected, analyzed, reported, and used for decision making.
CMS and HHS, with Congressional approval by funding HITECH have created a system of increased cost, poor design, and have sabotaged health providers in their already overbearing workflow.  They remain hiding behind future studies to prove something that is already self-evident. Res Ipsa Loquitor.
















61% of healthcare officials indicate terrible, poor ROI on EHRs, survey finds
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