Meaningful use overhaul loudly requested at Senate hearing as penalties loom

A Senate hearing revealed concerns about the Electronic Health Records (EHR) Incentive Program that was implemented to encourage providers to adopt updated health information technology (IT). The hearing, convened by the Senate Committee on Health, Education, Labor, and Pensions (HELP) and entitled America’s Health IT Transformation: Translating the Promise of Electronic Health Records into Better Care, brought together a wide array of professionals invested in the effort to revamp the system of health care records.

HITECH Act

The Health Information Technology for Economic and Clinical Health Act (P.L.111-5) allowed HHS to spend billions to promote the adoption of health IT. It also established meaningful use of EHR adoption to ensure that the implementation resulted in improvements in care. Senator Patty Murray (D-Wash) remarked that the HITECH Act played a large role in the significant jump in physicians who use EHR, from 18 percent in 2001 to 78 percent today.

Criticisms

Others testifying did not have many positive things to say about the effectiveness of meaningful use. Committee Chairman Senator Lamar Alexander (R-Tenn) is very concerned that almost 70 percent of physicians said “EHR systems have not been worth it.” Following the HITECH Act, providers rushed to adopt EHRs and join the meaningful use program. Half of these physicians have not met the requirements of the incentive program and are facing penalties. Although the deadline for compliance has been extended multiple times, many will not be ready when time is up, on March 20, 2015 (see Meaningful use deadline extended as HHS pledges to listen to physician input, Health Law Daily, February 25, 2015). Those who don’t adopt EHR systems will lose 1 percent of Medicare payments this year, and the penalty will grow. Providers have had to invest a significant amount of money in systems that were guaranteed to meet meaningful use requirements, but then needed costly upgrades or an entire overhaul of their IT system.

Dr. Robert L. Wergin, who owns a small rural practice and is the president of the American Academy of Family Physicians (AAFP), felt that overall, physicians are excited about future developments in health IT. However, he noted several struggles during his own transition to EHRs. He struggled to meet the criteria and experienced a loss of patient volume that still has not recovered to pre-EHR levels. Additionally, he finds that doctor-patient relationships have been negatively impacted by the struggle to meet regulations, and that the payment structure is inadequate.

Changes

Dr. Wergin and Senator Sheldon Whitehouse (D-RI) agree that meaningful use needs to see several changes. These include delaying penalties, overhauling documentation requirements, and including behavioral health and nursing homes. The past president of the American Health Information Management Association (AHIMA), Angela Kennedy, called for more oversight of information governance to ensure that data is both secure and correct. She has endured these struggles firsthand, due to her daughter’s misdiagnosis stemming from copy and paste errors in medical records. Senator Murray tried to remain positive about the future of the program and unite those involved “to do more to both set high standards, and ensure providers have the support and flexibility they need to reach them.”