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Slow Rise of EHR Adoption

Posted on September 21, 2011 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 love all the discussion that happens around EHR adoption. The funny thing about it all is that we honestly don’t really know. We don’t have any really solid number, because there’s no good way to measure EHR adoption. Plus, I think that we’d see drastically different EHR adoption trends based on location, practice size and specialty.

However, I think one thing is clear: EHR adoption has gone quite slow.

I read someone today talking about slow EHR adoption even in the midst of billions of dollars of incentives from the government. I think this is true. Even with all that money out there, doctors are still not adopting EHR software in droves.

Part of me says that this is a good thing. I think the worst thing that can happen to EHR is for a doctor who doesn’t want an EHR to adopt one. If they’re not on board with the idea of an EHR, then they just make work miserable for themselves and everyone around them. I see buy-in for an EHR implementation as the key determining factor for success of an EHR implementation. So, I don’t think we can force the issue.

As I consider this point, I was trying to think what movement or trend could make doctors want to implement an EHR in their clinic. One that popped into my head was insurance companies requiring use of an EHR. I know very few cash only doctors out there, so if they had to use an EHR to get their insurance payments, we’d see a drastic change in physicians perspective on EHR. Sure, some would still not like it, but they’d do it. I just don’t really see the path to where insurance companies will do this.

Another method will be if doctors start losing patients because they don’t have an EHR. We’re still a ways from this I think. I don’t think it’s clear in the consumer mind the benefits to them as a patient for the doctor to use an EHR. They’re going to get their prescription (or other healthcare service) either way. Should there be a new field on insurance companies list of providers that says “EHR User”?

What other trends could happen that would make EHR adoption basically a requirement to stay in business as a doctor? Thoughts on what could turn the tide. It seems the HITECH carrot and stick still isn’t totally moving the needle.

Major Insurance Companies and Meaningful Use

Posted on September 9, 2011 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.

We all know that the largest “insurance company” in the US (Medicare and Medicaid) is on board the meaningful use bandwagon. One of the major questions in the healthcare industry is whether insurance companies are going to hop on the meaningful use train as well.

I came across this post on Fierce Health Payer from August of 2010 (that’s a year ago for those keeping track) that talks about four major insurers aligning their pay-for-performance programs with meaningful use. The four payers mentioned are Aetna (NYSE: AET), Highmark, UnitedHealth Group (NYSE: UNH) and WellPoint (NYSE: WLP).

The interesting thing for me is that a year later, I still haven’t seen any real solid movement or announcements from the insurance companies about meaningful use. I may have missed it, so let me know if you’ve seen something, but I imagine one of my readers or someone on Twitter would have pointed out any major meaningful use announcement by private insurance companies.

I suspect that the major insurance companies are sitting back and watching the government’s meaningful use program first. I imagine they’ll be looking at which pieces of meaningful use are actually (excuse the term) meaningful and then use those as a basis for any initiatives that they launch. I’ll be really surprised if any insurer steps out and uses the meaningful use guidelines. They may use some elements, but I’ll be pretty shocked if they support all of meaningful use.

What do you think? How will insurance companies move forward when it comes to EHR and meaningful use?

Patient portals: no thanks for now

Posted on July 12, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

I recently read a blog post by Jennifer Dennard discussing an interesting electronic service for doctors and patients called Patient Point.  Apparently, it’s a service with strength in HIPAA-compliant doctor-patient communications. On one hand, I think this is a great idea. The concept of having electronic access to your doctor works well for most modern-day computer aficionados.  On the other hand, how does the doctor get reimbursed properly for time spent in this type of work?  If we’re talking about eliminating an office visit, but the work to be accomplished is basically an electronic office visit equivalent, then the payment to the doctor should remain the same.  How does this system allow the doctor to bill appropriately for potentially a lot of money?  Without such a clearly ironed-out rubber-meets-the-road provision, I think most private doctors will pass on this opportunity, which would then just be equivalent to an uncompensated time sink.

To further illustrate my point, about six months or so ago, I was excited to find CPT billing codes for telephone consultations, based on time spent providing healthcare by phone.  We tried billing this, for services rendered, to several patients’ insurance companies , including Blue Cross Blue Shield, Aetna, Cigna, and Medicare.  Every single one of these claims – each for about $10-$15 — were denied without exception, despite completely reasonable services rendered.  These phone conversations dealt with issues such as managing medication side effects, changes in current prescription medications, new prescription medications, and evaluating and managing new symptoms.  When we called in inquire with each insurance company as to the reason for denial, all said that while these codes existed for “some plans”, the specific patient that we were treating “unfortunately” didn’t have this plan feature.  All I can say is, yeah right.  I’m sure this is some type of loophole that makes the insurance company look good in some sense without actually providing any service to patients.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

Role of Insurance Companies in EMR

Posted on September 8, 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.

I get quite a few emails on this blog from various people. Lots are asking questions. Others rip something I said. Others say thanks for writing. In fact, that connection is one of the best reasons to blog. Well, someone asked the following question and I thought I’d open it up for people on this blog to comment about what they’ve seen, heard, experienced, or think should be done by insurance companies to promote EMR. Here’s the question:

Is there any role for insurance companies in this whole EMR area? Afterall, if quality of care can be increases and costs reduced, how can insurance companies encourage or help pay for EMRs?