PookieMD's Blog: Where Physicians Learn About the Business of Medicine

Argh, argh, argh and triple argh!  I can’t say it any stronger with out using words that would make my mother frown.  I am completely against the legislation known as the HITECH Act.

First, what is the HITECH act?  It is the piece of legislation that will reward “meaningful use” of an EHR beginning in 2011 or 2012.  In typical government-ese, here are the guidelines to reward meaningful use “by meaningful users.”

1. The eligible professional demonstrating, to the satisfaction of the Secretary, that he/she is using certified EHR technology in a meaningful manner, which shall include the use of e-prescribing as determined appropriate by the Secretary;

2. The eligible professional demonstrating, to the satisfaction of the Secretary, that such certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination; and

3. The eligible professional submitting information, in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the Secretary.

To encourage us all to become meaningful users, Mr. Obama, as well as Congress, is going to incentivize us to begin adopting EHRs.  (See table below for the plan to reimburse physicians for adopting EHRs and e-prescribing.)  Currently, depending on who you believe, anywhere between 4% (NEJM) and 10% of practices have an EHR.  Wave some money at the problem and all will be well, according to our esteemed legislators.

Not.

The biggest problem is that there is NO ONE EHR that we will all adopt.  Instead, practices can chose from one of a plethora of EHRs out there, blithely install them and happily (we hope)  begin using them.  It’s all good, until we try to communicate with each other.  It will be the Tower of Babel.  My EHR will not communicate with your EHR, and when a patient ends up in the  hospital, the hospital physicians will not be able to access records because, you guessed it, the hospital will have yet a different system.  It’s like paying states to have their own currency: it sounds okay, but try to pay in Wyoming with Wisconsin dollars.

Table: chilmarkresearch.com

So, what we have is a half baked plan that will definitely benefit the EHR/EMR industry, will cost approximately 19.2 billion, and will do little to improve patient care.  Yes, it’s sexy and hi-techy, but it is a huge waste of money and resources.  We must select a single EHR FIRST and then move forward.  With out adopting a single nation wide  EHR, the current plan is a completely wrong approach that will ultimately fail and cost more than it will ever be worth.