Thursday, August 25, 2016

Is the post-EHR era upon us? | Healthcare IT News

I would not be so bold as to claim the title of this blog.  However there are some that posit this idea.

Several mandates are still in effect.  As Mark Segal, chair of the HIMSS Electronic Health Record Association, reminds us: "Meaningful use is forever." And EHR  carries with it the long shadow of incentives and penalties which in the long run are very significant.

Many in the health and health IT industry are saying meaningful use is dead, due to it's complexity and the cost of upgrading current EMR systems to comply with CMS and HHS mandates. HIT vendors and health providers are justified in offering their opinion of non-attainability of the MU goal stage III.

Upon hearing of the Centers for Medicare & MedicaidServices' August Stage 2 rule change – ostensibly meant to offer more flexibility, but also requiring 365 days of EHR reporting in 2015 – CHIME CEO Russell Branzell struck an apocalyptic tone.
"CHIME is deeply disappointed," he said, echoing frustration held by many other stakeholders on the provider and technology vendor sides. "Now the very future of meaningful use is in question."
Upon learning of the rules newly-onerous requirement, one commenter on was more willing to put it definitively: "Lets all take a deep breath, and say it: Meaningful use is dead. Now is the time to figure out what to do next."
Whether or not there's any such thing as a "post-meaningful use" era, there's been plenty of discussion recently of a "post-EHR era" – one in which, with the basic commodity of electronic health records now in place and in use, the technology can evolve and improve: better usability and design, mobile device interfaces, more seamless interoperability. 
Although the vast implementation of EHR, MU I has taken place, many say it failed, largely because the Federal government hastily mandated a too short plan to implement it. They did the same with the Affordable Care Act. Passing both of these laws and the small print within was a political expediency...a rush to get it passed rather than a framework for success.  Success cannot be measured by one factor, as to how many people  have a card in their wallet which claims they have health benefits.  Most people do not have better care, cannot access a physician, and cannot afford the deductibles.

New to-do lists loom for 'post-EHR era'

It is patently obvious the regulatory burden increases each  year at the expense of patient care. Much of the "quality metrics" amount to checking off the boxes to reach HEDIS and MEDSTAR rankings. In some cases patient engagement is measured by how many times an insurer calls a patient without being asked to for things such as life issues, pharmaceutical needs. In one day I received three different phone calls from Human asking me if I needed any help.  I was offered a house call 'free' since they had a  mobile MD in my neighborhood. It took several 'NOs" to convince the care manager that I had just seen my doctor. The next call was from another case manager...about ten minutes apart wanting to review my medication list. The third call was from another asking me how I was doing after my spouse had passed six months ago.  This was a routine monthly checkup on my well-being.

On the face of it, it all seems well intentioned and that my doctors care about me. Perhaps I have become cynical....and perhaps there are patients that require this much pro-active care-giving. I am fortunate I have my wits about me (I think) even if I am 73, have had several major  heart adventures and one small stroke. Since I have young adult children they manage me quite well. (there should be an opt-out for the computerized checklist.  The whole thing is on automatic pilot, from voice mail to phone trees to managed care.  The infrastructure eats up any savings in actual patient care, in fact it seems as if the patient care savings were designed to finance the parasitic administrative burden.

Health insurers now practice medicine, they set the standards for payment, and use practice patterns to judge the quality of care. They call patients at home without permission or knowledge by the doctor....It is all okay because I am told the call is recorded for quality measures....(who listens to these recordings?

Are we in Kansas Dorothy ?

Is the post-EHR era upon us? | Healthcare IT News

1 comment:

  1. Certainly, health IT is growing really fast. With a lot of big companies participating and focusing on effective telemedicine services, even smaller firms can get exposure; as people adopt more of these services. This is definitely a good development as it improves the overall efficiency and quality of our current healthcare system.