In a recent article at Physicians Practice, James O/’Connor, MD describes well the current EHR climate:
Physicians’ responses are all over the map. A surprising number of our colleagues still don’t know about meaningful use. Some doctors plan to ignore it altogether. (It appears that the fewer the number of years to retirement, the greater the apathy towards meaningful use.) Some practices are optimistically and enthusiastically making plans. Others are revealing their ambivalence, wrestling with the question “should we or shouldn’t we?”
I whole-heartedly support the adoption of electronic health records. I was an early adopter in my own practice and have spent a good deal of time in the industry. I am aware that the majority of my colleagues remain resistant to EHRs.
Nonetheless, the pros and cons of meaningful use are not really the problem. The problem is that, once again, we physicians are subject to a mandate over which we have little control and no choice whether to comply. Is this surprising to you?
He then goes on to make the case for why doctors really don’t have much choice but to comply with meaningful use of an EMR system. His reasons are essentially:
1. HITECH EHR penalties
2. Major Insurer adoption of meaningful use
3. ABMS Maintenance of Certification program adoption of meaningful use
4. Board Certification meaningful use requirement
We’ve talked about pretty much all of these reasons in the past on EMR and HIPAA.
1. The EMR Stimulus Medicare penalties don’t amount to a whole lot.
2. I think major insurance companies are in wait and see mode for commercial insurance adoption of meaningful use. They definitely want more data, but I think they’re not sure meaningful use is going to give them that data.
3. I don’t know much about ABMS and how that works for cash only doctors. Maybe someone can tell me why this matters in the comments. I guess you need this certification to practice medicine on a cash basis?
4. I thought I wrote about this before, but I can’t find the article. I guess it’s possible. Isn’t board certification done on a state by state level? I must admit that it just seems weird that to practice medicine you somehow would have to show meaningful use of an EHR. What about recent grads? I don’t know, this just doesn’t make much sense to me.
Dr. O’Connor describes the choice as follows:
OK, so technically, we do have a choice. We could stop taking Medicare and Medicaid patients, accept cash only, give up our board certification (and thus usually hospital privileges), and move to a state (or country) that doesn’t impose EHR requirements. But is that really a choice? No.
He does then encourage active participation in the discussions of meaningful use so that you can affect it for good. I agree this is a good thing and an important act. I believe Meaningful Use stage 2 will be greatly impacted by 1. public comment and 2. experience in meaningful use stage 1. It’s important that doctors are part of this conversation or I think they’re going to be unhappy with MU stage 2.