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August 5, 2011 News 2 Comments

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Why IN-Eligible Professionals Should Still Buy and Implement Certified EHRs
By Mary Stroupe

8-5-2011 11-09-05 PM

If you don’t bill Medicare or Medicaid, you don’t qualify for federal Electronic Health Record (EHR) incentives. However, you should still implement a certified EHR if you want to keep patients and fellow physicians highly satisfied.

Our Movement Toward National Information Exchange and Interoperability

The US healthcare system is moving toward electronic health information exchange (HIE). Today, data is shared electronically among providers using Regional Health Information Organizations (RHIOs). Soon, a Nationwide Health Information Network (NHIN) will enable immediate, authorized access to patient data (similar to banking access provided by the ATM network). The goals of a NHIN are to reduce medical errors, duplicate tests and healthcare costs. Another goal is to provide patients with access to medical records, which are currently scattered across multiple medical entities.

How Interoperability Supports that Movement

The goals of the NHIN can only be realized by interoperability among EHRs: the ability to send and receive clinical data that means the same thing in whichever system it is viewed. The key to interoperability is standardized data. Just as data is standardized in other industries (like banking, to make ATMs work), medical data must be standardized so clinicians can properly interpret it.

How Certified EHRs Support that Movement

Certification is the single variable ensuring the EHR you purchase meets national interoperability standards. Two types of certification exist: ONC-ATCB (ARRA) certification and CCHIT Certification 2011. ARRA (or “Meaningful Use”) certification is what is minimally required for government reimbursement. CCHIT Certification 2011 provides an additional level of assurance that the product meets a more rigorous security inspection and complies with specific functionality, workflow, and usability criteria.

Why a Certified EHR? For Patient and Physician Satisfaction

With the steady growth of Personal Health Records (PHRs), patients will expect you to provide their health data electronically. Why? For eligible professionals to receive government reimbursement, they must be able to supply patient data electronically when it is requested of them. Once savvy patients realize they can get it, they will start asking for it – from all their providers, not just the ones who received incentive payments! Without an EHR and data that certifiably meets national standards, you will be unable to provide patients with data that can be shared with their PHR. If patient satisfaction matters, this matters.

As the wave of EHR adoption rolls across the US, physician offices will no longer staff to levels required to deal with paper (e.g., hard copy referral notes). Providers will exchange data electronically, using standardized data sets that make it possible. It is reasonable to expect, then, that referral providers may avoid colleagues who cannot provide data electronically. If physician satisfaction matters, this matters.

The Bottom Line

Providers who do not implement interoperable, certified EHRs risk becoming data islands to their patients and fellow providers (like a bank that cannot connect to the ATM network).

Mary Stroupe is President of Integritas, Inc. in Monterey, CA.

Comments 2
  • I completely agree with the point of your article however it should be noted that HIE’s are not necessary to achieve interoperability. As a matter of fact, they may hinder true interoperability as they create “walled gardens” that necessitate that both the sender and receiver are part of the same “hub” or have a direct exchange address specifically linked to a particular HIE which means that your data is going through their system. This is not what was intended by HHS when they launched the Direct Project. All that is needed is a direct exchange address, a digital certificate, the Connect open source software and an email client to create a true peer-to-peer connection between sender or receiver. This eliminates all of the maladies that a data warehouse creates as it relates to back ups, up time, security, data translations, etc., etc. The answer for the typical provider is a direct health information exchange as envisioned by the HHS.

  • Where do you think the “hybrids” fit in?

    1) HIEs with EHR/EHR-lite functionality (Medicity’s free iNexx – http://www.medicity.com/inexx-introduction.html)

    2) EHRs with HIE/HIE-lite functionality (Mitochon System’s free ehr/hie/phr – http://mitochonsystems.com/why-mitochon/)

    I think the current RHIO model that Mary mentions is where care coordination works – the Direct Project provides a “care coordination lite” since all of the data can’t be seen or acted upon (duplicate testing again) but at least there is a standard in which EHR silos can plug into. A definite plus

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