Widespread adoption of electronic medical record (EMR) systems in the future is a noble objective, however it has distracted policy makers from enabling true Health Information Technology (HIT) reform now. While others continue to champion EMR systems as former U.S. Department of Health and Human Services National HIT Coordinator David Brailer, MD, did, many in the health sphere confuse the advancement of EMRs with overall HIT reform. As industry pundits debate potential clinical benefits and cost reductions that EMR systems could deliver, there is too little discussion about how HIT can improve the single largest payer of medical claims—Medicaid.
Healthcare executives face an uphill struggle to reduce costs, grow revenues within a shifting payment landscape and ensure that patients receive quality, life-saving care. A tough assignment, especially when a critical shortage of workers sabotages those efforts.
In the past two years, not-for-profit hospitals have faced increasing scrutiny from a variety of sources. Lawsuits alleging unfair billing practices for the uninsured, congressional hearings regarding hospitals' tax-exempt status, federal and state legislative policies regulating hospitals' provision of charity care and front-page articles in major newspapers outlining overly aggressive efforts to collect payments from uninsured patients have all conspired to put this healthcare sector on red alert.
In a unanimous decision (Sereboff v. Mid-Atlantic Med. Svcs.) released on May 15, 2006, the U.S. Supreme Court permitted a health insurer to enforce a reimbursement provision against a participant. The plan had paid approximately $75,000 for the treatment of injuries suffered by the participant, Marlene Sereboff, and her spouse, who subsequently received $750,000 pursuant to a third-party tort settlement. The health plan provided that a participant who is injured by another person and receives benefits under the plan for such injuries must reimburse the plan from any amount recovered, without reduction, for failure to receive the full damages claimed. When the participant refused to comply with this reimbursement provision, the insurer obtained an injunction requiring the Sereboffs to set aside sufficient funds from the settlement, pending a final ruling in the case.
With its first phase of certification rolling, the Certification
Commission for Healthcare Information Technology (CCHIT) will
concentrate on maintaining its momentum while moving to the realm
of inpatient electronic health records (EHRs) in its second
certification phase, followed by the evolving EHR network
infrastructure in phase three.
Building and applying the technology of the electronic health
record (EHR) is a decidedly non-magical process far more complex
and less instantaneous than just making the paper disappear into a
wastebasket. Quality concerns about EHR systems must be addressed,
which is why the Certification Commission for Healthcare
Information Technology (CCHIT) exists. A voluntary, private-sector
initiative based in Chicago, CCHIT was established in 2004 to
foster the adoption of robust, interoperable health IT in the
United States through product certification. In 2005, CCHIT
received a three-year contract from the Department of Health and
Human Services, making it the key entity to develop and evaluate
criteria for the testing and certification of EHR systems in the
Privatization of Medicare Part D has led to the emergence of many
players, both large and small. Navigating CMS regulations and
subsequent guidance has resulted in some administrative burdens, as
well as the inability to employ many managed care techniques, say
Sure, e-mailing your doctor about that tickle in your throat or the
recurring rash on your arm sounds like a great deal—no
appointment needed and no copayment. But what if there is a price
tag, albeit small, to e-mail your doctor about non-urgent medical
problems? Would you still choose this communication vehicle?
Electronic Health Records (EHRs) are the future of health information management, and today the calls for a massive industrywide transition to EHRs are even louder.
The push for electronic health records (EHRs) and their physician-originated counterpart, electronic medical records (EMRs), gained significant momentum in 2005. In fact, today's discussions now include subcategories to distinguish the interests of one group over another. We can expect the implementation of some versions of the EHR?including portable EHRs, payer-based EHRs, ambulatory EHRs and inpatient EHRs?to become more widespread.