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MGMA Blames Rise in HIT Costs on Fed’s Regs

Posted on September 15, 2016 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manager doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst, a role he recently repeated for a Council member.

MGMA’s released a study of 850 member’s practices showing HIT costs up by more than 45 percent in the last six years. MGMA puts much of the blame on federal regulations. It’s concerned that:

Too much of a practice’s IT investment is tied directly to complying with the ever-increasing number of federal requirements, rather than to providing better patient care. Unless we see significant changes in the final MIPS/APM rule, practice IT costs will continue to rise without a corresponding improvement in the care delivery process.

There may be a good case that the HITECH act is responsible for the lion’s share of HIT growth for these and other providers, but MGMA study doesn’t make the case – not by far.

What the study does do is track the rise in HIT costs since 2011 for physician owned, multispecialty practices. For example, MGMA’s press release notes that IT costs have gone up by almost 47 percent since 2009.

In fairness, MGMA also notes that costs may have also gone up do to other costs, such as patient portals, etc. However, the release emphasizes that regulations are at great fault.

Here’s why MGMA’s case falls flat:

  • Seeing Behind the Paywall. If you want to examine the study, it’ll cost you $655 to read it. Many similar studies that charge, provide a good synopsis and spell out their methodology. MGMA doesn’t do either.
  • Identifying the Issue. It’s one thing to complain about regulations. It’s quite another to identify which ones specifically harm productivity without compensating benefit. MGMA cites regulations without so much as an example.
  • Lacking Comparables. MGMA’s press release notes that total HIT costs were $32,000 per practitioner. However, this does not look at non HIT support costs, nor does it address comparable support costs from other professions.
  • Breaking Down Costs. The study offers comparable information to practitioners by specialty types, etc. However, all IT costs are lumped together and called HIT.
  • Ignoring Backgrounds. MGMA notes that HIT costs rose most dramatically between 2010 and 2011, which marked MU1’s advent. It doesn’t address these practices’ IT state in 2009. It would be good to know how many were ready to install an EHR and how many had to make basic IT improvements?
  • Finessing Productivity. Other than mentioning patient portals, MGMA ignores any productivity changes due to HIT. For example, how long did it take and what did it cost to do a refill request before HIT and now? This and similar productivity measures could give a good view of HIT’s impact.

It’s popular to beat up on HITs in general and EHRs in general. Lord knows, EHRs have their problems, but many of the ills laid at their doorstep are just so much piling on. Or, as is this case, are used to make a connection for the sake of political argument.

Studies that want to get at the effect HIE and EHRs have had on the practice of medicine need to be carefully done. They need to look at how things were done, what they could accomplish and what costs were before and after HIT changes. Otherwise, the study’s data are fitted to the conclusions not the other way around.

MGMA’s a major and important player with a record of service to its members. In this case, it’s using its access to important practice information in support of an antiregulatory policy goal rather than to help determine HIT’s real status.

#HIT100: Healthcare IT Embraces Twitter in a Big Way

Posted on July 20, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

It’s not secret that social media continues to play an increasingly powerful role in connecting folks within the healthcare IT community. Sites such as LinkedIn, Facebook and Twitter offer easy-to-navigate platforms that enable communication with peers on any continent, in any time zone. Twitter has become a personal favorite – both for its brevity and its simplicity. (Yes, I’ve heard promising things about Google+, but haven’t yet checked it out.)

The healthcare IT community has also embraced Twitter. Follow a variety of hashtags, including personal favorite #HITsm, and you’ll encounter a variety of opinionated, educated, and often humorous industry folk who, through their activity in the social space, are either emerging as thought leaders or bolstering their credibility as one.

The hashtag #HIT100 has been popular of late thanks to the crowdsourcing efforts of Michael Planchart, aka @theEHRguy. According to his Twitter profile, he is a “Healthcare Interoperability Consultant, Enterprise Architect for Healthcare IT and Standards Specialist.” According to his LinkedIn profile, he is a chief software architect at ProKSys. One thing is for sure – he is passionate about the healthcare IT community on Twitter. So much so that just a few weeks ago he began compiling nominations from his peers on Twitter of the top 100 tweeters (personal or company accounts) in the healthcare IT space.

The resultant list, published earlier this week, can be downloaded here: Final HIT100 Nominees. It is a great resource of folks to keep up with. (Be sure to check out @billians at #78!) Anne Zieger at (@ehroutlook at #86) has helpfully distilled the list into the top EMR/EHR tweeters.

I’ve met many in person at industry events, and know even more through Twitter. Hopefully I’ll run into Michael Planchart himself at some point. In the meantime, I chatted with him via email about why he wanted to take on this project, and why the healthcare IT community has embraced social media, particularly Twitter.

Why did you decide to embark on this project?

I wanted the healthcare IT community to vote for their most valued peers. Many well-intended folks would come up with their personal list and publish it. I wanted everyone to participate to create a more objective and transparent selection. This one may not yet be perfect, but it is open and publicly created. Hopefully, for 2012 we will have greater participation from many more folks. But for now, we have this to evangelize from.

Do you think there are more influencers in the #HIT space this year than last?

I know many of the folks that I follow and those that follow me. I’ve personally met many at RSNA, HIMSS and other healthcare events. But I’ve noticed a lot of newcomers to the social media space. Many of them I know as excellent contributors to healthcare IT, since I belong to the same standards committees that they do, although many times we work on different projects. What’s new is not them being in healthcare IT, but being in social media representing healthcare IT.

But answering your question more directly, yes there are many more participants this year. To be an influencer like John Halamka, Brian Ahier, Keith Boone, Matthew Holt and Dave deBronkart, just to name a few, most have some miles to go.

And why do you think there has been such an increase?

Twitter has been an open platform to create networks from the beginning. Linkedin and Facebook are too closed to create peer-to-peer networks. So Twitter has been highly influential in creating these peer-to-peer specialized networks like our #hcsm or #HIT groups.

I encourage you to take a look at the list and start connecting, communicating and educating. Be sure to follow this blog – @ehrandhit, and myself – @SmyrnaGirl, while you’re at it!