Electronic Health Care Program Threatens More Efficient Setting of Care | Commentary

Posted September 29, 2014 at 4:46pm

Recently at National Health IT Week, health care experts gathered to emphasize the importance of improving the quality of health care delivery and strengthening the interaction between patients and healthcare providers. For good reason, adoption of Electronic Health Records is largely lauded as a necessary, even overdue step to improve efficiency and ultimately the quality of patient care.

As hospital systems and large physician practices boast widespread adoption of EHR, achieving the maximum possible benefit of a fully interoperable system remains largely unknown. How the government chooses to steamroll forward with implementation could make or break years of achievement and improved patient care.

There is a serious concern about a largely unnoticed anomaly in the EHR program that would penalize medical professionals who treat Medicare patients based on the setting in which they practice. Should, let’s say an ophthalmologist, elect to perform cataracts surgeries on the majority of his or her patients in an ambulatory surgery center, this would result in a failure to meet the current requirements mandated by the Health Information Technology for Economic and Clinical Health Act of 2009.

This is a tragedy for the American health care system. ASCs were once widely accepted as the new cutting edge for health care delivery. These modern facilities provide same-day surgical care and have transformed the outpatient experience for millions of Americans by providing them with a more convenient, top-quality alternative to hospital-based outpatient procedures.

Caring for patients, particularly those who are elderly or suffer from multiple chronic conditions, at an ASC prevents possible exposure to germs and infections that are more prevalent in the hospital setting. It’s the answer to patient choices when it comes to certain, appropriate surgical procedures.

Not surprisingly, research validates the value of ASCs. The U.S. Department of Health and Human Services, the University of California at Berkeley, and most recently Health Affairs, have each conducted research that reveals ASCs not only save the Medicare system billions of dollars, but also saves beneficiaries hundreds of millions of dollars each year in copayments.

The benefit of ASCs to beneficiaries is not merely financial — patients who are treated in an ASC typically experience excellent outcomes and high satisfaction rates.

In 2013, approximately 6.5 million procedures in the Medicare system were performed in the ASC setting, which means the potential for future savings is substantial.

Today, the success and growth of ASCs may soon backpedal. Remember that the HITECH Act, which created the certification standards and incentives for physician offices and hospitals to adopt EHR technology, did not include provisions for ASCs. This means that there was never any incentive funding for ASCs to purchase EHR systems. Even if an ASC wanted to purchase an EHR, which most — if not all would — there is not certified EHR technology available on the market.

With no certified EHR to purchase, providers who practice at ASC will be left accountable for the financial penalties for failure to comply with the law.

What’s most puzzling is the fact that ASCs relish the opportunity to highlight the high quality, cost-efficient care they provide, and a certified EHR system is a crucial step in doing so. In fact, independent of federal funds, the industry began to develop its own path toward health record technology.

Until such technology is available, should physicians be forced to choose between providing qualities, cost effective care in the ASC, while suffering financial penalty from the government, or treat Medicare patients in a higher cost setting at the taxpayers’ expense?

We oppose unnecessary and undue burdens that threaten to hinder advancement and waste taxpayer funds. Together, we introduced the Health Records Fairness Act in order to stop any EHR penalties for physicians who treat patients in an ASC. For the EHR program to work as intended, for systems to talk to one another, and for all to be on the same page, this oversight must be corrected.

Rep. Diane Black is a Republican from Tennesssee; Rep. David Scott is a Democrat from Georgia.