Forcing EMR's on Physicians
More bad news for doctors related to the ever increasing demands by third party payers.
The report coming out of the Boston area states that Partners Health Care, a large health care system, is demanding all primary-care physicians in its contracting network to implement or sign a contract for an electronic health record by Jan. 1, 2008.
Those physicians refusing to invest the tens of thousands of dollars for this will be expelled from the network. By 2009, the same requirement will be applied to the bulk of Partners’ specialists.
Physicians can choose between one of two systems and if they already have a system, they will only qualify if it has specified decision-support features demanded by the network.
There are roughly 1,100 primary-care doctors in the network and about 700 are in private practice. This demand from the network is noteworthy because it’s believed to be the first U.S. health-care system to, in effect, force private-practice doctors to get EHRs.
There is no guarantee of any increase in reimbursement for these physicians and it is unfortunately a huge mandatory increase in expenses for the practices.
Big brother is not only watching, he is now kicking you around as well!
The report coming out of the Boston area states that Partners Health Care, a large health care system, is demanding all primary-care physicians in its contracting network to implement or sign a contract for an electronic health record by Jan. 1, 2008.
Those physicians refusing to invest the tens of thousands of dollars for this will be expelled from the network. By 2009, the same requirement will be applied to the bulk of Partners’ specialists.
Physicians can choose between one of two systems and if they already have a system, they will only qualify if it has specified decision-support features demanded by the network.
There are roughly 1,100 primary-care doctors in the network and about 700 are in private practice. This demand from the network is noteworthy because it’s believed to be the first U.S. health-care system to, in effect, force private-practice doctors to get EHRs.
There is no guarantee of any increase in reimbursement for these physicians and it is unfortunately a huge mandatory increase in expenses for the practices.
Big brother is not only watching, he is now kicking you around as well!
Labels: contracts, EMR, healthcare, managed care
posted by Anonymous at 5:55 AM
7 Comments:
What is the stated logic & reasoning behind Partners Health Care's decision? Is it to give PHC billing & auditing instant access to the records of the patients/insureds, or is there some other reason?
Ostensibly, I'm guessing its a means for PHC to review physician coding & billings versus what appears in the chart. However, to the extent it puts private & protected health information into the hands of third parties, I'm with you, its shocking.
On a similar note, I was really surprised to recently recieve a letter from my health insurer giving me a statistical breakdown of my "compliance rate" with my cholesterol medication prescription for the past 6 months. They took the number of prescriptions and factored in the number of days to let me know how compliant I had been as far as a percentage. It made me wonder what business of theirs it was (as an insurer, not my physician), and more importantly, how & where that information is stored, and how it might be used in the future for things like premium raises & whatnot by their underwriters.
The information age when it comes to health care is really a double edged sword.
The complaint about the cost to doctors in private practice is missing the point. Like small farmers who can't afford efficient, but expensive, equipment or small shopkeepers who can't afford to match prices with more efficient competitors, the day of the small medical practice is nearly over. It was fun while it lasted, but it is OVER. Doctors' traditional method of delivery service Monday through Friday between 9:00 AM and 4:30 PM is OVER. Winners in the future will combine in very large practices, sometimes in the hire of hospitals or other corporate owners and they will provide 24/7 service which makes more efficient use of space, equipment and personnel resources. Electronic medical records is just one requirment to play in the future. There will be more and the quick and the smart will survive and the slow and the reluctant will wither. It has happened in plenty of other industries and it is happening in yours. Welcome to 2007.
To LAWGUY:
I found it interesting to read your comment about receiving a letter that gave a breakdown on your "compliance" rate with your medication. I, too, have received one such letter. And I, too, wondered what the ramifications of this knowledge would be. I was particularly concerned because their information was incorrect. It is based on the number of prescriptions submitted by your pharmacy for reimbursement. It did not take into consideration that my MD had given me samples.
Dr. Dan: you have been on an EMR system for a few years. What is your take on this kind of system inside your office. I unerstand there is a significant learning curve to impliment. But after it is in place, your practice operates a great deal more efficiently. How has it affected your turn around time for billings?
Is it possible to get ahead of the game with the insurance companies? I am suggesting seeking help from our legislators to protect patient privacy. After all, they too will be affected by this new approach.
Unfortunately, we already sign a release of information form to allow the insurance companies access to our medical record. But can a line realistically be drawn as to how much they really need?
Google: "CMS Physician Focused Quality Initiative"
From Nov 2007 Minnesota Medical Assoc magazine:
"...a major concern among practicing family physicians, who say the current reimbursement model fails to pay them appropriately for providing high-quality, comprehensive health care, particularly for patients with chronic conditions. According to Medical Economics’ annual income survey, median compensation for family physicians, internists, and pediatricians was about $150,000 in 2004, whereas the median was $215,000 for ob/gyns and about $300,000 for urologists and noninvasive cardiologists.
The reason for the gap is that the health care reimbursement system generally rewards fragmentation, high-tech wizardry, and procedure-oriented medicine, say family physicians, which runs counter to family medicine’s mission of providing holistic, patient-centered care that emphasizes communication and consultation between patients and providers.
“It’s not uncommon to have a patient with 20 different problems and 12 different medications; but we don’t get paid for being their medical home and coordinating their care,” says Dawn Blomgren, M.D., medical director of Northwest Family Physicians in Crystal. “We might have to look at everybody’s notes and coordinate, but unless we have a specific diagnosis that someone else is not getting paid for, we could spend 30 to 45 minutes and not get reimbursed. Yet someone can sit and do cataract surgery over and over again and get paid three times what we do.”"
It seems to me that EHR is the only way to address this discrepancy. Shouldn't primary care physicians be embracing this?
EMR's, EHR's etc. help with documentation but really have not been found to significantly improve overall patient care.
Just as hospitals are transitioning to them as well, it is more for documentation purposes to keep all the overseers and attorneys at bay.
We have spent more than $150,000 on our EMR's and that doesn't include the annual maintenence costs.
The odds of the system recouping the cost is slim to none.
This was taken from a physician aquaintance in New York, explaining CCHIT to his patients. There are far scarier motives hidden in this agenda than the professed goal of standardizing health records.
Anonymous
Warning:
Time is running out and your attention and immediate actions are required. As of early this coming year we, as your family’s healthcare provider, will have no choice but to enter part of your child’s health records in a centralized, New York State run database and server!
After 10 years of approximately only 5% compliance from NYS doctors and their patients, the state is now mandating us to enter your child’s shot records in their database! Perhaps the other 95% of us know something worth considering? First, let me state in the strongest terms possible that I firmly believe in properly vaccinating all of my pediatric patients on the appropriate pediatric schedule, and so not vaccinating is in no way part of this argument. Instead, it is that all pediatric patients must be entered into this system. Although patients 19 years of age or older can “opt-out”, we parents as legal guardians of our own children can not do likewise for any of them that are below this age cut off. Time is running out and your action is required immediately, because as of right now all provider’s offices are being required to sign up for and attend training on this system so we can all “comply” with this terribly invasive and unconstitutional new law.
As a concerned citizen I personally do not want my children in this centralized, state run database. This is the beginning of an “Orwellian” type system of having all citizens’ health records in centralized state run databases. Just as New York State is implementing its own illegal database of your child’s health records there are larger and more ominous forces at work here that want to complete this invasion of your privacy nationwide with a new system that will contain everyone’s entire medical history! I kid you not…
There is a federal government and large private software vendor supported and sponsored “committee” that wants to do the same for all of our health records, compiling them in regional systems that will be tied together nationally. This is basically a self anointed committee with its own very biased agenda called C-CHIT; for Committee on Health Information Technology. They want to be the only game in town for their large sponsoring software vendors and the large insurance industry by “certifying” EMR’s, EHR’s (Electronic Medical or Health Records), but stifling their competition is only one of their objectives. The Newest “standards” just passed by this out of control “committee” that answers to no one, requires that all “certified” EMR’s must have a permanent backdoor “portal” to allow any and all insurance companies (including government ones) into yours and your doctor’s health records! Obviously this is to facilitate their ability to spy on your doctor and your health records that we have always felt an ethical obligation to protect. Let me assure you that as of today our small, non-CCHIT Certified EMR, “Amazing Charts” has no such spying mechanism in it and that Paul and I will be carefully monitoring for such things.
There is a growing movement against this committee, their oppressive standards and their ill intent, in the small and solo practice community of providers across the county. Unfortunately, we are small and fragmented. But with your help as the constituents of our elected officials to take a stand and speak out against these assaults against our liberties we might stand a fighting chance to defend them. Let “them” know in no uncertain terms, that what is in your chart, your health record is nobody’s business, be it the government or the large insurance industry; but that of you and your treating physician. Tell them to keep their hands off of your charts and to keep their prying eyes out of your chart and your doctor’s office. Thank you.
The NYS Vaccine Registry is coming right now and needs to be addressed immediately before it is too late and begins the last phases of its implementation. CCHIT is coming pretty soon too. NYS has authorized an “assistance” program thru the state medical society (of which I have yet to renew my membership mostly in protest of such things) to help small struggling offices in implementing health information technology, but only CCHIT certified EMR’s quality for these state grants, so my office does not qualify for what basically amounts to a corporate hand out and welfare program. So, CCHIT will need to be fought at both the state and the federal levels. Again what we need most is your help to speak out against such awful things. At least your freedom of speech and rights of collective action has not been as badly restricted as ours has been.
Unfortunately, when doctors try to act collectively, especially against the large insurance industry, the FTC (Federal Trade Commission) tends to get involved and punishes doctors for infringements of freetrade. This is why so far all attempts by doctors to organize or unionize against these colossal giants have quickly failed. Now you know why we have so little leverage or clout to stand up to these large greedy insurance companies. Basically the deck is so stacked against us that it is against the law for us to do such. This effectively keeps us from advocating strongly and collectively, be it for ourselves or for you our patients.
So lastly, please let them all know that your doctor needs the same rights as everyone else to act and bargain collectively, so as to be able to exercise some amount of like kind leverage back against these greedy, anti-health, for profit giants. There is a bill in Albany on this that just never seems to get through.
In closing let me assure you that my staff and I will do what ever is practical and possible to defend and protect your privacies and your liberties. As a proud American, I simply believe doing such is the right thing to do. But we are a very small business with limited resources, that many with less than good intent have intentionally tied up in knots, so we really need your help. Thanks for listening and for your help. We will try to keep you informed as things evolve.
In Your Good Health,
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