HIT article for MIAMI MEDICINE

[Edmund Billings]

> ----- Original Message -----
> From: Bernd Wollschlaeger <in...@miamihealth.com>
> To: Walter Groszewski
> Sent: Thu Jun 11 20:47:14 2009
> Subject: Latest HIT article for MIAMI MEDICINE
>
>
> Medical Information Technology
> Your Monthly IT Guide since 1995!
>
> Electronic Health Record Certification (EHR):
> How Industry Lobbyist’s and Politicians Stifle Competition
>
> By Bernd Wollschlaeger,MD,FAAFP,FASAM
>
> The Department of Health and Human Services (HHS) said that the
> Medicare
> and Medicaid health IT provisions in the American Recovery and
> Reinvestment Act (ARRA) are designed to promote and provide incentives
> for the adoption of certified EHRs.
> To achieve this goal, the ARRA authorized bonus payments for eligible
> professionals and hospitals participating in Medicare and Medicaid
> as an
> incentive to become meaningful users of certified EHRs.
> Physicians who implement a certified solution and become meaningful
> users between 2010 and 2012 will be eligible for up to $44,000 each in
> incentive bonus payments in addition to Medicare and Medicaid
> reimbursement.
> Physicians who wait to become meaningful users between 2012 and 2014
> will be eligible for lower payments. Physicians who have not become
> meaningful users by 2015 will not qualify for any payments and will be
> subject to increasing penalties. Starting in 2015, eligible
> professionals and hospitals failing to meaningfully use certified EHRs
> will receive reduced Medicare payments.
> Incentives are based on the lesser of either 75% of the provider’s
> Medicare Part B billings or the maximum allowable.
> The statute includes three broad criteria for demonstrating one is a
> "meaningful EHR user" which will be defined as the implementation
> process moves forward: (1) Meaningful use of certified EHR technology;
> (2) information exchange; and (3) reporting on measures using EHR.
> The problem is that the regulatory agencies have yet to define what
> the
> term “certified EHRs” encompasses and includes. The current
> certification process is being administered by the Certification
> Commission for Healtcare Information Technology (CCHIT), a private
> nonprofit organization with the sole public mission of accelerating
> the
> adoption of robust, interoperable health information technology by
> creating a credible, efficient certification process. The Commission
> operates with a nine-member volunteer board of Trustees, 21 volunteer
> Commissioners who represent all sectors of health IT and provide
> strategic guidance and oversight for the certification process and
> criteria, and 170 volunteers who serve on 15 workgroups and bring
> their
> expertise to the process of creating the certification criteria. There
> are now approximately sixty EHR products certified to this standard,
> in
> the marketplace and ready for adoption and use and one would expect
> more
> products to get certified from which the growing numbers of physicians
> and hospitals can choose form. Not so according to industry lobbyist
> and
> politicians! There seems to be substantial and significant pressure
> from
> large vendors, whose representatives sit on key committees and were
> major contributors to the presidential election campaign, and from
> certain politicians to choose one particular certification regime
> above
> all others and to limit the discussion about the contained metrics.
> According to a proposed bill in New Jersey, (New Jersey Health
> Information Technology Promotion Act) “ a prohibition on the ale or
> distribution of in this State [New Jersey] of HIT [Health Information
> technology] products that have not been certified by CCHIT [yet] will
> expedite the widespread use of CCHIT-certified products in New Jersey
> and thereby advance the public interest..”
> That means that already established and certified vendors will knock
> out
> smaller and emerging product developers, even though those may offer a
> better and more cost-effective product! Needless to say that the big
> EHR
> vendors are salivating over the opportunity to eliminate all
> competition
> and thereby also innovation. A true scary thought when big industry
> and
> big government unite to scuttle free market competition! What’s the
> solution?
> Well, according to several postings on a web site called
> www.sensiblecertification.com we should resist any efforts to stifle
> innovation in a rapidly advancing field, that may increase the cost of
> health information technology and preferentially reward specific large
> vendors
> What can we do? We are asking the Obama administration to consider
> sensible certification. Sensible certification will be a boon to the
> health care industry if it 1) Focuses on inter-operability,2) Keeps
> the
> door open for innovation,3) Describes the desired end state while
> allowing varied approaches to flourish.
> I look forward reading your to your comments and suggestions on our
> blog
> at http://miamimedblog.blogspot.com/ or send us a twit at
> http://twitter.com/dadedoc .
>
> Disclosure: The author is a practicing family physician, addiction
> specialist and computer consultant. In addition, he is a founder and
> managing partner of a medical IT company.
>