In an opinion piece in the Baltimore Sun last week, Ritu Agarwal related her personal experiences about the problems with paper-based patient records and in a very convincing way made a case for EHR adoption.
While Agarwal is not your typical consumer - she is professor and Robert H. Smith Dean's Chair of Information Systems at the University of Maryland's Robert H. Smith School of Business, as well as founder and director of the Center for Health Information and Decision Systems at the Smith School. She is also biased, but she can be forgiven her biases because of her all-too-common experiences.
The fact that practically everyone has a similar story to tell should help with consumer understanding and acceptance of EHRs. What we should be also talking about, and quite forcefully now that healthcare reform on the access side has been mandated, is payment reform. Agarwal touched on this ever so briefly, but really, EHR adoption won't be successful until we have true payment reform.
When I talk about payment reform, I mean we need to overhaul the way private and public payers reimburse healthcare services. As far as the public payer component, CMS is already tied into the program with its incentive program, but cutting rates shouldn't be its only payment method for IT adoption. There should be a broader, deeper reimbursement mechanism on the public payer side. One hopes that ONC is working with CMS to develop reimbursement pilots.
On the private side, commercial payers need to take a lead because they would be one of the biggest beneficiaries of a low-cost, high-quality healthcare system. They could also stand to repair trust and their reputation with consumers. So they need to develop pay-for-performance programs that reward meaningful use of health IT, including improving clinical outcomes.
They ought to subsidize health IT implementation with their network providers. They should work to help integrate financial and claims systems with EHR and EMR systems to make the IT systems seamless in the way
There is a lot of work to be done on the payment side before we can declare victory on the health IT adoption side. We need more experts to espouse the benefits in a public awareness campaign. We need the right stakeholders to willingly come to the table to create solutions. Finally, we need really smart people to develop innovative reimbursement models that reward health IT implementation and meaningful use.
Patty Enrado blogs daily at EHRWatch.com.
