MDNews - Central New York

The Electronic Health Record: Look How Far We Have Come BY JOHN NETTI THE MA SSIVE CHANGES facing physi- cians from the recently passed Medicare Access a nd CH I P R eaut hor i zat ion Act of 2015 (M ACR A) w i l l soon be upon us a nd rely heav i ly upon data from electronic hea lth record (EHR) systems. Implementing the new pay- ment model for hea lthcare providers under the MACR A legislation, which is referred to as the Merit-based Payment Incentive System (MIPS), would have been unimaginable with the technology available just ten years ago. The role of information technolog y has exploded since then, making it possible to now incorporate information from multiple sources and create a comprehensive electronic patient record. Information such a s labs, radiolog y repor ts a nd images, prescribed medications a nd summaries of care from hospitals and other practices, continuously flowing in and out of systems among providers, is now the norm. For decades, the idea of automating patient hea lth records seemed like it was for enthusiasts only. During the '80s and '90s, EHR adoption rates inched along at the bottom of projected growth charts. The reasons for this included a lack of national clinical standards, silos of patient information locked inside d ispa rate systems, h ig h cost s a nd, most notably, the lingering question of whether or not an EHR could add value to patient care. A ll of this cha nged however, a f ter the national tragedy of 9/11. National safety fears prevalent at the time and out of healthcare control costs created a national consensus that change was needed. Aided by the emergence of break- through technologies and a new and stronger leadership role by the federal government, the stage was set for the changes prevalent today. After a few years of self-examination p o s t 9/1 1 , P r e s i dent B u s h i s s ue d Executive Order 13335 in April 2004. It has proven to be a hallmark initiative that led to the new age of hea lthcare information technology we know today. The executive order involved building a nationwide technolog y infrastruc- ture that would serve as a foundation to "improve the quality and e¬ciency of health care" for all Americans. The e•ort engaged thousands of people in technolog y and healthcare sectors. It also established the O¬ce of National Coordinator for Hea lth Information Technology, which oversees technology regulations and standards. President Obama's administration made the EHR e•ort truly bipartisan w it h t he en a c t ment of t he Hea lt h Information Technology for Economic a nd Clinica l Hea lth (HITECH) Act, which is part of the American Recovery and Reinvestment Act of 2009. This pushed EHR adoption into the strato- sphere by using a number of financial i ncent ives a nd pena lt ies. In 20 0 4 , approximately 20 percent of off ice- based physicians were using an EHR. Today, that figure has nearly quadrupled, according to HealthIT.gov. HITECH also established the concept of meaningful use as a means of measur- ing the successful use of systems by providers. It created programs, such as the Regional Extension Center, that help physicians use systems e¬ciently. Also, a steady stream of federal money wa s f unneled to t he states to bui ld health information exchanges (HIEs) that connect with EHRs for sha ring clinical information. The capability for providers to securely access electronic information through public and private HIEs is now bringing the coordination of care to a new level. Soon, the building phase of the new health information age will be over, and the focus will shift to how to best use the information it creates to improve patient ca re, public hea lth a nd cost e¬ciency in care delivery. The recent MIPS legislation lays out a roadmap for a new way to pay healthcare providers based on clinical outcomes and quality. It will begin in 2019 and will have as its foundation the use of EHR technology. Using these EHR systems will soon become as second nature for physicians as using a stethoscope. The question about whether it was worth it to spend billions of dollars trans- forming health information technology and the incalculable e•ort invested by healthcare organization personnel won't be answered for decades. But it is irrefut- able that what has been accomplished is a reminder that, as with the other major national endeavors such as the building of the first intercontinenta l railroad or winning the race to the moon, great achievements are possible when people unite behind a common cause. Looking back at the past 10 years gives those of us who remember when medical billing was being done manually pause to say: "Look how far we have come." John Netti is President of the EHR Advisory G roup, LLC, which provides an array of EHR, HIPA A and PQ RS ser- vices to medical organizations. For more information go to ehradvisorygroup.com or call 315- 437- 4377. ■ 1 2 1 2❱❱❱❱❱ M E A N I N G F U L U S E

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