Federal Incentive Programs Encourage Physician Offices to Implement EHR

In February 2009, President Obama signed into law the American Recovery and Reinvestment Act (ARRA), a $789-billion economic stimulus package. Included in the AARA legislation was the Health Information Technology for Economic and Clinical Health Act (HITECH). This act allocated $19 billion to hospitals and physicians who demonstrate “meaningful use of electronic medical records.” For private-practice pediatricians who furnish at least 20 percent of their outpatient services to Medicaid patients, that means a potential monetary incentive totaling $63,750 over six years between 2011 and 2021.

“Electronic health records provide a variety of benefits, foremost among them quality care and safety for patients, practice efficiency and patient satisfaction because of the immediacy with which files may be accessed,” says Amanda Heidemann, MD, FAAFP, medical director, EHR for BJC Medical Group. “The HITECH incentive is designed to provide a very real amount of money to help defray physicians’ cost of transitioning to electronic health records.”

The push toward EHRs supports the goals set by the Office of the National Coordinator for Health Information Technology (ONC), which also receives HITECH funding. The ONC is aiming toward “the utilization of an electronic health record for each person in the United States by 2014.” It also seeks to develop a nationwide health information technology infrastructure that allows for the electronic use and exchange of medical information.

The key to incentives: meaningful use

In order to qualify for HITECH incentive payments, pediatricians must meet measurable benchmarks, termed “meaningful use” by the ONC. It will be measured in three stages over five years, with each stage representing a level of adoption:

• Stage 1, data capture and sharing—electronic capture of health information in a structured format (begins this year).
• Stage 2, advanced clinical processes—quality improvement at the point of care and electronic exchange of information (scheduled to begin in 2013).
• Stage 3, improved outcomes—improvements in quality, safety and efficiency in clinical decision support and patient self-management tools (scheduled to begin in 2015).

In Stage 1, “meaningful use” consists of 20 criteria that show pediatricians are using their EHR as an effective tool in their practice. Examples of these mandatory criteria are:

• Record patient demographics at least 50 percent of the time.
• Record vital signs at least 50 percent of the time.
• Maintain active medication lists at least 80 percent of the time.
• Provide patients with a clinical summary for each office visit within three business days at least 50 percent of the time.
• Generate electronic prescriptions at least 40 percent of the time.

“Obviously, implementing an EHR takes time and a real effort on the part of physician practices,” says Dr. Heidemann. “Physicians must carefully weigh the HITECH financial incentive versus the benefits to patients, which are substantial. This is truly what the future holds for patient health records, and physicians have a real opportunity to take advantage of not only the monetary incentive but also the decision-making and implementation support offered through HITECH.”

Choosing an EHR

With more than 400 EHR software programs on the market, choosing one to implement could be daunting. Fortunately, the ONC has narrowed the field by certifying specific EHR products that must be used in order for physicians to qualify for participation in HITECH. In addition, the ONC has established regional extension centers in each state and the District of Columbia to help physicians, hospitals and other qualifying medical professionals select the EHR option most suitable to their needs.

To learn more about HITECH incentive programs, visit the following websites:

- Missouri HIT Assistance Center, www.assistancecenter.missouri.edu

- Illinois Health Information Technology Regional Extension Center, www.ilhitrec.org

BJC Medical Group is developing several approachesto make it easier and more affordable for private practice providers to obtain electronic health record (EHR) technology. For additional information, contact Nancy Specking at nms2119@bjc.org

Table: Medicaid Eligible Provider Incentive Payments

*First year in which the Medicaid eligible provider qualifies to receive incentive payment.