I read an editorial by a veteran physician assistant based in Pickens, N.C., who is a long-term user of EMRs. He has recognized the clinical and financial benefits of health IT and is definitely a physician champion.
The roadblock to having a fully automated physician practice is the administrative red tape thrown up by insurance companies, according to Henry Ramirez, physician assistant at Upstate Medical Associates in Seneca, N.C. He says pre-approval processes create delays in treatment and a lot of staff time is spent on administrative requirements, which takes away from the timeliness and cost and resource savings gleaned from EMR adoption.
I definitely understand that point of view. There are key stakeholders in healthcare delivery - the patient, provider and payer. And they all have to interact. Ideally, all the processes should be smooth to ensure patient access to high-quality care.
Ramirez says that all aspects of health IT should focus on high-quality care and access to medically necessary treatments. Further, he says payers shouldn’t be able to manipulate the health IT implementation process by putting up restrictions on test, treatments, prescriptions and procedures ordered by the physician.
So what's the solution? According to Ramirez, it's the proper implementation of the recent health reform legislation. Return control of decision-making to the physician through the use of health IT. But what does this really mean? By design, health IT systems provide clinical decision support through evidence-based medicine.
Perhaps the answer is not in the reform legislation but in the consumer market. With ARRA driving EMR and EHR adoption, more consumers will get a taste of the conveniences automated, electronic processes provide them. That ought to translate to choosing health plans with their wallets to get these services, which should alert payers that they need to support health IT for their network providers.
I don't think you'll find many opponents to wresting control of healthcare services and decisions from payers and giving it back to physicians. Health IT will certainly help them do a better job. If the industry agrees to follow evidenced-based medicine, which would positively impact outcomes and cost, ideally the roadblocks would go away. And what better way to give physicians EBM but through their EMRs and EHRs.
