Stimulus Bill Calls for Better Patient Care, Via EHR Adoption

Although progress toward adoption of electronic health records (EHRs) has been inconsistent in the past, the alignment of technological advances with new government incentives under the recently passed economic stimulus bill could move the needle significantly. There is considerable interest in EHR adoption because many experts believe wide use and interoperability of patient health information systems stands to improve health care quality, reduce medical errors, enhance the physician-patient encounter and lower health care costs.¹

These goals are incorporated into the American Recovery and Reinvestment Act of 2009 (ARRA), which President Barack Obama signed into law on Feb. 17. The Act provides an estimated $19 billion in incentives over a five-year period for physicians and hospitals to integrate and use certified EHRs in their practices. After that five-year period, the law imposes an escalating reduction in reimbursements for nonadoption of EHRs.

“The buzz around EHRs right now is unprecedented, thanks to the stimulus bill,” according to Bill Miller, executive vice president of health care delivery systems, Ingenix. “For the first time, the federal government is taking an extraordinary role in driving development and adoption of EHR technology to improve patient safety and make physicians’ jobs easier,” he said.

Physicians seeking EHRs that help patients

The health information technology (HIT) provisions in the ARRA specify the use of a qualified EHR, which is characterized as “an electronic record of health-related information on an individual that includes patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to provide clinical decision support; to support physician order entry; to capture and query information relevant to health care quality; and to exchange electronic health information with and integrate such information from other sources.”²

To be eligible for the Medicare and Medicaid program incentives, which range from $42,500 to $63,750³ over a five-year period, physicians are required to meet a “meaningful use” standard for certified EHRs. This standard will be defined by the government by the end of 2009. Ingenix and the Health Information and Management Systems Society (HIMSS), among other entities, have formulated comments regarding the definition of “meaningful use.”

On April 24, HIMSS published its recommended definitions of meaningful use, recommending that EHRs enable “electronic exchange of standardized patient data with clinical and administrative stakeholders,” provide “clinicians with clinical knowledge and intelligently-filtered patient information to enhance patient care,” and offer “capabilities to support process and care measurement that drive improvements in patient safety, quality outcomes, and cost reductions.”

Ingenix agrees that any EHR implementation should deliver positive, measurable effects on patient care, and that such efforts should require defined improvement benchmarks. Without such measures, progress toward achieving stated objectives cannot be determined. Physician practices also play a critical role in developing, applying and leveraging EHR capabilities, according to Susan Bresee, director of business development at Ingenix Consulting.

“Even as the government drives toward its definition of meaningful use, the HIMSS guidance offers clear direction for those considering EHRs now,” she said. “Physician practices should embrace this opportunity to position themselves early to meet the criteria. In doing so, they can shape EHR development and press vendors to deliver solutions that meaningfully support their practice and ability to improve patient care.”

In the past, some physicians have expressed concern about whether the benefits of EHRs outweighed the investment required to implement them. The stimulus bill offers some encouragement to physicians. “By setting standards for meaningful use and putting the money directly in the hands of physicians,” Bresee said, “the federal government is helping to push this valuable initiative forward with real purpose.”

Technology shrinks cost, workflow obstacles

Better design and technological capabilities also are helping to clear hurdles to EHR adoption. In the past, costly and cumbersome electronic record systems that hindered practice workflow stopped many physician EHR efforts in their tracks, Miller explained. He noted that recent innovations are enabling physicians to find an EHR system that not only meets the government’s requirements but also supports their practice and billing workflow and maximizes the benefit of their time with patients by, for example, streamlining patient charting, making referrals seamless and facilitating electronic prescriptions.

Ingenix can provide physicians with both the technology tools and the support they need to get their EHR systems up and running. The company offers Ingenix CareTracker EMR, a CCHIT-certified,⁴ Web-based electronic medical record (EMR) application that can be implemented for as little as $5,000 per year and allows physician practice electronic records to be accessed seamlessly from any location through a secure and centralized gateway.

With CareTracker, authorized users can log in to their EMR and Practice Management systems via a secure Web browser. Once logged in, they can access patient records and review medications, patient history, recent orders and test results. The system fuses clinical, billing and administrative workflows together and integrates them with Ingenix coding and compliance solutions.

This coordination of incentives, cost-savings and interoperability may be the key driver spurring on greater use of EHRs. “If the technology is really useful to the doctor and he sees the value in it, he will use it,” Ingenix CEO Andy Slavitt said in a recent interview with the Morningstar Health Observer.⁵ “For example, the ability to see a patient’s lab results right away and discuss them with the patient while he’s still in the office – that’s useful.”⁶

CareTracker EMR saves Trumbull thousands

One practice that has achieved positive results with Ingenix CareTracker EMR is Trumbull Medical Practice LLC in Trumbull, Conn.

Trumbull was able to reduce costs, increase revenue per patient and improve patient care by using Ingenix CareTracker EMR. “Ingenix CareTracker was the perfect solution for our needs,” said Scott Hill, office manager for Trumbull. “In addition to reducing costs, CareTracker has increased our efficiency, improved our billing and ensured that we receive the proper level of reimbursement for the services we provide,” according to Hill.

Indeed, Trumbull is expected to gain a cumulative five-year benefit of $224,655 due to a reduction in software licensing fees and revenue increases enabled by improved documentation and higher collection percentages. “I would recommend it to other practices,” Hill said. (A case study of Trumbull’s experience with CareTracker can be found here.)

EHR expertise makes the difference

Properly implemented, an EHR can transform a physician practice, notes Bresee. “With CCHIT certification, we’ve arrived at a point where selecting an EHR provider is not so difficult,” she said. “The challenge is in developing an EHR strategy and then designing a system to collect the right data and deliver it in a meaningful way. That requires unique expertise in managing data quality and use.”

Ingenix Consulting has worked with hundreds of physician offices and multiple vendor systems to select, implement, deploy and support EHR initiatives. Whether a physician practice is planning an initial EHR implementation or has an existing investment in EHR technology and is looking to achieve the optimization goals identified by the ARRA, identifying a consulting partner can be an essential step toward success.

“Ingenix Consulting experts are knowledgeable in all aspects of EHR implementation, from solution design to project management and application consulting. We’ve helped thousands of people through the transition,” Bresee said. “Regardless of which EHR vendor physicians partner with, Ingenix Consulting can help them achieve better patient care more quickly and efficiently.”

Bottom line, she said, “Ingenix Consulting brings collective knowledge and a comprehensive view of implementation that allows us to deliver EHRs to physician practices in a way that increases care quality while decreasing the barriers to success, which include cost, delivery of care during deployment, training, network connectivity, security and compliance.”

Physician EHR success is attainable

With success stories like Trumbull’s and others emerging, “physicians are starting to see how EHRs can help them save time, manage their practices more efficiently and focus more time on patient care,” Bresee said. “With the addition of incentives for adopting an EHR, physicians have every reason to make changes and move forward now.”

Working with Ingenix can provide physicians with an even greater comfort level, because regardless of the EHR model a practice chooses, “we can walk people through the process and optimize their results,” Bresee said. “It may be the first time a physician has walked this road, but Ingenix has been down it countless times before.”

For more information about government incentives for implementing EHRs or for more information about Ingenix CareTracker EMR, visit www.ingenix.com/stimulus, call 800-765-6074 or send email to ingenuity@ingenix.com.

¹ American Recovery and Reinvestment Act of 2009, H.R. 1, Title XXX, Sec. 3001.
² Id., Sec. 3000.
³ “H.R. 1, the ‘American Recovery and Reinvestment Act of 2009’ explanation of Health Information Technology (HIT) Provisions,” American Medical Association.
⁴ CCHIT (The Certification Commission for Healthcare Information Technology) confirms that Ingenix CareTracker, Version 6.2 from Ingenix is a CCHIT Certified Ambulatory EHR product for 2007.
⁵ “Interview with CEO Andy Slavitt of UnitedHealth’s Ingenix,” Morningstar Healthcare Observer (April 2009).
⁶ Id.

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