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Regional Extension Centers (Finally) Help Docs Get Incentives

Posted on August 3, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

For a while there, it seemed like the RECs didn’t have their act together, particularly when it came to reaching out to and closing the deal with doctors. Getting the right person on the phone wasn’t that easy, in fact. Well, times change. A new report suggests that the RECs have gotten on top of things.

The new study, which was issued by the General Accounting Office, concludes that healthcare providers who partnered with a REC — a step which involves a modest fee — were more than twice as likely to get an incentive payment under the Medicare incentive program.  The data in the report comes from 2011, and drew on varied government sources.

On a related note, the GAO reported that 2,802 hospitals and 141,649 professionals registered for the Medicare incentive program last year. Of that group 761 hospitals and 56,585 professionals got incentive payments through Medicare.

The agency also took a look at which types of hospital were more likely to get the Medicare incentive, and got some unsurprising results (summary courtesy of EMR Daily News):

Critical access hospitals were less than half as likely to earn incentives as acute care hospitals.

Hospitals in the top third of size (measured by number of beds) were 2.4 times more likely than hospitals in the bottom third to earn an incentive payment.

Nonprofit and for-profit hospitals were 1.1 and 1.5 times more likely than government-owned hospitals, respectively, to receive an incentive payment.

Only one in ten (12.2 percent) of eligible rural hospitals were awarded Medicare EHR incentive payments.

Taken as a whole, I  see this as a “good news/bad news” situation. One the one hand we have the welcome news that the REC program is actually delivering on its promise, something I imagine we’re all glad to see.

On the other, the critical access/rural hospital numbers are simply unacceptable. There’s no reason that people in these hospitals would be any less capable of meeting Meaningful Use standards, but they lack the staff and capital needed to push their efforts along. Ultimately, this could lead to a major disparity in care for Americans living in remote areas.

I’m not sure what the answer is here — other than perhaps a FAT load of grants for such hospitals helping them with MU efforts — but something has to be done.  I’m pretty sure that “the rich hospitals get richer” wasn’t HHS’s intent for MU.

Defense Department’s EHR Effort Falters

Posted on October 7, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

From reader DKBerry:

You’d think that buying a common EHR platform and deploying it across all of Defense Department’s medical centers (Army, Navy, Air Force) … that they would have done better.  How did VA succeed where DoD is failing?

Unless the Defense Department addresses weaknesses in project planning and management that have hampered its current electronic health-record system’s capabilities, it risks undermining its new EHR initiatives, according to a Government Accountability Office report (PDF) requested by Sen. Judd Gregg (R-N.H.), the ranking minority member of the Senate Budget Committee.

The report notes how the Defense Department has obligated some $2 billion since 1988 to an EHR system for the 9.6 million active-duty service members, their families and other beneficiaries but has come up short and has scaled back its original expectations for AHLTA. (AHLTA was originally an acronym for “Armed Forces Health Longitudinal Technology Application,” but the department later declared it was no longer an acronym, but a brand.)

After finding AHLTA’s early performance “problematic” in terms of speed, usability and availability, the Department of Defense has sought to acquire a new system known as EHR Way Ahead, according to the report.

The new system, according to the GAO report, “is expected to address performance problems; provide unaddressed capabilities such as comprehensive medical documentation; capture and share medical data electronically within DOD; and improve existing information sharing with the Department of Veterans Affairs,” and has initiated efforts to “stabilize” AHLTA so it can act as a bridge until the system is ready.

The Defense Department has allocated $302 million in its 2011 budget request, according to the report, but has not changed its EHR acquisition process to avoid the same shortcomings it experienced with AHLTA.

Source

Issues with VA Vista EMR

Posted on November 10, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

So many people have propped up the VA’s EMR system (Vista) as the model for how EMR should be done.  This story about the GAO finding the EMR implementation over budget is really interesting.  Here’s just one short section about the budget that they have for the VA EMR:

VA officials cited resource availability and interdependencies among projects as key drivers of cost and schedule variances. The GAO has estimated that the program will overrun its current budget – worth approximately $1.897 billion – by $350.2 million.

WOW! That’s a lot of money. I would hope that if you’re spending close to $2 billion you’d have something good to show for it. Too bad it’s just not reasonable for most doctors offices to spend that kind of money.

Here’s another interesting quote from the article (emphasis added):

VistA-FM is designed to provide a framework as well as additional standardization and common services components. It’s also intended to eliminate redundancies in coding and support interoperability among applications. However, VA officials have told the GAO that VistA-FM is costly and difficult to maintain and doesn’t integrate well with newer software packages.

I’m sure the MUMPS fans will come out of the wood work and tell us how great it is. I’m sure it does some things very well. However, I agree with the quote from this article is that it doesn’t integrate well with newer software packages. This is a major problem if we’re talking about inter operable EMR software.

Vista is free for doctors offices. I think it’s the “difficult to maintain” issue that kills most people even with the free price tag. Of course, my focus is on ambulatory EMR. The hospital environment is a mess regardless of which EMR you choose.