While health information technology (IT) has been shown to help improve patient safety, increase coordination of care and identify and track areas for quality improvement, there is still room for enhancements, particularly in the areas of interoperability and administrative requirements, according to a CardioSurve survey conducted this past May.
The survey revealed that adoption and use of health IT has continued to grow, in part because of the federal Electronic Health Record (EHR) Incentive Program, or “Meaningful Use” program. Nearly one in three cardiologists surveyed (32%) said their technology purchases have been expedited as a result of the program, which provides financial incentives for EHR use, as well as penalties for lack of use. Cardiologists currently participating in the Meaningful Use program have fared well so far. According to recently released data from the Centers for Medicare and Medicaid Services (CMS), cardiology as a specialty received the largest share of incentive payments under the EHR program as of March 2013, with 12,948 cardiologists, or roughly 50% of the total number of cardiologists in the country, receiving EHR incentive payments.
While this is great news for cardiology, there are still several major challenges associated with using health IT to deliver coordinated care. Cardiologists indicated that the top two challenges involve the need to log on to different EHR/data sources to obtain all relevant records (70%) and the inability to use mobile devices to access medical records from other facilities (65%). Other challenges included incompatibility between different systems and office equipment and administrative burdens, such as the need to frequently print documents in order to use information or the inability to open CDs brought in by patients containing medical records or study results.
“Slow computers, frequent errors, too many scanned documents and duplications,” one cardiologist stated. Another noted: “I waste a lot of time day to day navigating electronic and paper records – I would rather use that time doing patient care or research.”
Of these challenges, the need to share clinical data (e.g., ECGs, diagnostic images and patient data from other facilities) across different providers, as well as across different medical devices, was considered most critical. More than 85% of survey respondents believed that it was important for their medical devices to share clinical data on a daily basis, yet 72% of respondents acknowledged that making such sharing happen is difficult.
More than 75% of those surveyed also stressed the need for a solution, with 87% indicating they would be supportive of a standards-based, vendor-neutral solutions approach for connecting clinical devices. The College is considering such a program with Integrating the Healthcare Enterprise (IHE) that would facilitate the integration of clinical devices in cardiology practices and improve device interoperability. The resulting solutions would be provided at no charge to the end users.
The one caveat, however, is that in today’s increasingly integrated health care environment only 8% of those surveyed indicated the ability to make any decisions regarding health IT and EHRs on their own. The vast majority of those surveyed (73%) had varying degrees of influence in the health IT decision making process. Any collaboration would need to include comprehensive participation details targeted at all relevant stakeholders.
Unless a change occurs in the current law, eventually cardiologists and other physicians who do not implement EHRs soon will face reductions in their Medicare payments. Specifically, cardiologists who do not complete their first year of participation in the EHR Incentive Program by Oct. 1, 2014 will face a one-percent penalty in 2015, and the penalties will increase to at least three percent in 2017 for those not participating by 2016. While one to three percent may not alone comprise a significant penalty, it can incrementally grow if it is coupled with a decision not to participate in the Physician Quality Reporting System (PQRS) and value-based purchasing programs (where applicable), which also include penalties for those who decline to participate.
Whether collaborating with IHE or joining forces with other medical societies and/or the government on initiatives and tools to aide in EHR adoption and use, the ACC is committed to helping members minimize the challenges of health IT and maximize the benefits. Learn more at ACC.org/HealthIT.
“I think it makes absolute sense to make relevant information easily accessible and to have standardized formats in the industry” – Cardiologist in Illinois