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The Impact of Healthcare Reform on Medicine

Posted on December 1, 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.

I must admit that I don’t post that often about healthcare reform and the changing doctors practice. Not to mention things like the Accountable Care Organizations (ACO) and other trends in healthcare. Although, I do watch them peripherally and in many cases these changes are important in relation to EMR since they impact what the future of EMR might look like.

So, I was pretty interested in a post by Barbara Duck about the impact of Healthcare Reform on medicine as we know it today. Barbara has a quote which describes the change:

“Healthcare reform will usher in a new era of medicine in which physicians will largely cease to operate as full-time, independent, private practitioners accepting third party payments.”

Then, she quotes a study which describes how medicine will change and the four possible courses that physicians will take amidst all this change.
• Work as employees of increasingly larger medical groups or hospital systems
• Establish cash-only practices that eliminate third party payers
• Reduce their clinical roles by working part-time
• Opt out of medicine altogether by accepting non-clinical positions or by retiring.

This information isn’t all that new. I also have read many people who just see this as the same cycle that we’ve seen before. I think that’s probably true, but it’s still a cycle that should be considered going forward.

Assuming the above assumptions are correct, does that spell the end of the small practice EMR software? Essentially it would leave only EMR software that supports larger medical groups or hospital systems and EMR software that handles cash only practices (something every EMR vendor would probably love to do).

Personally I don’t see it as the end of small practice EMR software. Although, it definitely will see a shrinking of the market for that software. At least temporarily.

EHR Incentives (HITECH Act) Likely Safe With New Congress

Posted on November 8, 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.

Gov Info Security recently published their thoughts on the possible effects of the new Congress on the EHR incentive money known as the HITECH act.

Republicans, however, have made it clear that they’ll look for any opportunity to repeal some or all of the healthcare reform package. Observers say that means the HITECH Act likely won’t get as much attention, even though the EHR incentives are funded by President Obama’s economic stimulus package.
“One of the things that the Republican ‘pledge to America’ includes is a plan to take away any unobligated stimulus money,” says Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society. “I don’t think that’s going to apply to the HITECH provisions. Folks on the Hill tell me that health IT is a bipartisan issue. Democrats and Republicans see it as a way to improve healthcare.”

Nevertheless, Republicans will closely scrutinize all spending, Roberts acknowledges. “And they’re going to take a close look at all the provisions of the HITECH Act to make sure they’re being implemented as directed by Congress.”

Even if the presumed new speaker of the House, John Boehner, R-Ohio, was to push for spending cuts, such as eliminating the EHR incentives, getting such a proposal approved would prove very difficult, Roberts argues. “With the two chambers of Congress controlled by different parties, getting them to agree on something will be next to impossible,” he says.

In addition, President Obama, who is strongly supportive of healthcare IT, likely would veto any cuts in HITECH spending, notes Rob Tennant, senior policy adviser for the Medical Group Management Association. And overriding a veto would prove extremely difficult.

I tend to agree. Certainly something crazy could happen (it’s government work after all), but I think the likelihood of HITECH Act funding being taken away is pretty slim. As it describes above, it would take a really unique piece of legislation to get it through the house, senate and then the President. I just don’t see that happening at all.

Plus, I thought the point of the money being so far along in the regulation process is another good reason. Although, since checks haven’t been paid out yet, I’m guessing that there’s still potential that they’ll put it on hold. Just seems really unlikely to me.

2010 Election Results Impact on EMR Stimulus Money and Other Health IT Policy

Posted on November 3, 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.

Many in the health care IT and EMR world have been waiting to see the election results from last night. There’s been a reasonable fear about what impact the election results might have on the EMR stimulus money and other healthcare IT policies. The HIMSS blog described some of the details of the changes we saw last night:

The United States Senate has stayed in Democratic control, but with a much smaller majority. Senate Majority Leader Reid from Nevada survived a tough re-election, but is much weakened going forward. Senate Democrats will now have to look at whom they want to lead the Senate over the next two years. They will vote by secret ballot in the near future.

The United States House of Representatives will now be controlled by the Republicans when the 112th Congress convenes in January 2011. President Obama called the presumptive next Speaker of the House, Rep. John Boehner, last evening to congratulate him on his party’s victory and promise to work with him. With the House and Senate held by different parties, compromise will be even harder to find in the 112th Congress.

The current 111th Congress will reconvene in a few weeks to complete unfinished business before adjourning permanently either this month or next month.

I’m not so sure I agree that Reid has been weakened so much by the results of this election. He won and he’s seen as a guy who is great at strategy in Washington. So, I have a feeling that he’ll be back as Senate Majority leader again with just as much power. I say this as someone living in Nevada.

This part aside, I think the fact that the Republicans only took control of the house and not the senate likely is a good thing for the EMR stimulus. I heard one person tell me that the EMR stimulus money has pretty good bipartisan support in the government. I think this is generally true and that it will only be taken away if it’s a casualty of the unspent ARRA stimulus money and not because they specifically didn’t want to spend money on EMR.

I still think this is a possibility, but I personally believe it’s a small possibility. I don’t think the Senate will really allow that to happen. Instead they’ll focus on other things (possibly healthcare reform instead).

I’m interested to hear what other people think. What other effects will the election have on healthcare IT policy?

Healthcare Reforms Impact on EMR

Posted on March 26, 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.

I’m out of town now at a leadership retreat. So, I decided I’d pose a question and hopefully a number of people will leave comments with their thoughts on the subject. Now for the question:

What type of impact will the most recently passed “healthcare reform” bill have on EMR adoption and use?

Effect of Obamacare on EMR Industry

Posted on March 16, 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.

One of my readers sent me the following email…

New England Journal of Medicine survey:
46% of primary care physicians would quit if Obamacare becomes law!

I’m not sure I agree with the statement. Should I? If this does happen, how will it affect the EMR industry? Should EMR vendors should be preparing for the healthcare reform (Obamacare) in their projections?

Inertia in Healthcare Is Sometimes a Good Thing

Posted on July 21, 2009 I Written By

President Barack Obama is defending his relentless campaign for a health care bill before Congress’s August recess, saying “the default in Washington is inaction and inertia.”

Mr. Obama, there is a good reason for inertia. It protects complex systems which have evolved over time from dramatic change which can be very disruptive and threaten the very survival of the system. Inertia moderates change so that change can be accomplished slowly and successfully. Inertia is sometimes a good thing. In the case of healthcare reform, this inertia might save our healthcare system.

Improving our healthcare system is an important project. This cannot be done in 3 months by politicians and bureaucrats who are not expert or experienced in the ways of healthcare. The system must evolve slowly, thoughtfully and carefully.

The goal should NOT be universal coverage at the expense of everything else! Universal coverage is a worthy goal, but there are other things which are more important like quality of care, cost of care, ability to access care, innovation and properly aligned incentives. Universal coverage puts EVERYTHING else at risk and therefore we need to pause, take a deep breath and figure out how we are going to improve our health system without ruining it and putting our whole economy at risk.

The experiment in Massachusetts has been a disaster. It has achieved the goal of universal coverage but the cost of care has gone up and access to care is terrible (not enough providers). Doctors are miserable, not making any money and they are leaving the state. Let’s look very closely at Massachusetts before we duplicate this disaster at the national level!