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Saturday, January 26, 2019

Doctors and Hospitals Say E-Record Goals Are Unrealistic - The New York Times

This article dates back to the dawn of electronic health records in 2009.  Not much new today, 9 years later. Most medical practices utilize electronic health records despite being unrealistic, inefficient, and reducing physician time with patients.  Most doctors spend their time gazing at a computer screen rather than engaging with their patient face to face.

The feds accomplished their goal. to set up a system whereby they could extract data to analyze.  I have yet to see any studies regarding the use of Electronic Health Records vs ballpoint technology in regard to changes in quality improvement.

The shape of this article give one little hope for following any recommendations by the federal government.  One thing is for certain, those physicians who advised our system were either ignored or they gave bad advice.

WASHINGTON — In February 2009, as part of legislation to revive the economy, Congress provided tens of billions of dollars to help doctors and hospitals buy equipment to computerize patients’ medical records.
But the eligibility criteria proposed by the Obama administration are so strict and so ambitious that hardly any doctors or hospitals can meet them, not even the most technologically advanced providers like Kaiser Permanente and Intermountain Healthcare.
Doctors and hospital executives, who have expressed their frustration in meetings with White House and Medicare officials, said the issue offered a cautionary tale of what could happen when good intentions meet the reality of America’s fragmented health care system.
The goal of the law is to provide financial incentives, through Medicare and Medicaid, to encourage doctors and hospitals to adopt and use electronic health records. When the bill was passed, the Congressional Budget Officeestimated that the incentive payments would total $34 billion.
It is no surprise that tiny hospitals in the Midwest and doctors practicing by themselves would grumble about the White House proposals.
Continue reading the main story
But elite institutions have similar concerns. Among those expressing deep reservations about the proposals are pioneers in the use of health information technology like Kaiser, Intermountain, the Mayo Clinic and Partners HealthCare System in Boston, which includes Brigham and Women’s Hospital and Massachusetts General Hospital.
One of most revealing assessments came from Dr. Thomas H. Lee, president of the physician network at Partners HealthCare.
“Effective use of electronic health records will greatly improve patient safety, quality and efficiency,” Dr. Lee said in a letter to Medicare officials. But he said the approach taken by the administration was based on “unrealistic expectations” and “unachievable timelines.”
“We are very concerned about the requirement that hospitals and eligible professionals must meet each and every one of the objectives to demonstrate meaningful use and thereby qualify for incentive payments,” Dr. Lee said.
In meetings at the White House, doctors and hospital executives have conveyed the same message: the president’s all-or-nothing approach could discourage efforts to adopt electronic health records because some of the proposed standards are impossibly high and the risk of failure is great. They pleaded with the administration to take a more gradual approach and reward incremental progress.
At least 27 senators and 245 House members echoed those concerns in letters to the administration.
Administration officials said they took the concerns seriously, but refused to say whether they would relax the proposed requirements.
“We want to strike a balance,” said Jonathan D. Blum, deputy administrator of the Centers for Medicare and Medicaid Services. “We will provide flexibility for doctors and hospitals, but push them to elevate their performance. Final rules will be out in early summer.”
Anthony A. Barrueta, the vice president for government relations at Kaiser Permanente, said his company, the nation’s largest nonprofit health plan, had years of experience with electronic health records, but could not meet all the criteria for incentive payments.
Dr. Brent E. Wallace, chief medical officer at Intermountain Healthcare, in Utah, said the administration’s criteria were “too rigid, requiring too much change in too short a time.”

Doctors and Hospitals Say E-Record Goals Are Unrealistic - The New York Times: Critics say the Obama administration’s criteria for computerizing medical records are too strict and ambitious.

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