Doctors Raise Doubts on Digital Health Data

Articles published in the New England Journal of Medicine’s April issue present a bleaker picture for the $19 million, multi-year electronic health record (EHR) initiative included in the Stimulus Package adopted last month.

The papers point to greater obstacles—practical and financial—than previously thought.

One article, based on a study by the federal government and the Robert Wood Johnson Foundation, reveals only 9 percent of 3,000 hospitals surveyed have EHRs. A second opinion article by health information management (HIM) directors at Children’s Hospital Boston maintains the financial program could be a costly policy mistake.

For more information, read the article on the New York Times Web site.

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8 Responses to “Doctors Raise Doubts on Digital Health Data”

  1. Marlene Wright says:

    What most of the wonderful people in our federal government dont seem to understand is that the time, money and efforts that many physicians will have to put forth for this EMR revolution is just not there. Ask any physician and they will tell you that just the rigor of making it through a day with all the work needed to just treat a patient is about all they can handle. What the government really needs to do is rake the insurance carriers over the coals a few times and get them in gear.

    These carriers have literally just about put many of them in a place where they cannot make it and the thought of having the extra burden of being forced to use EMR or get penalized is the final blow.

  2. Janet Snyder, MS, CPC says:

    In regard to Marlene Wright’s comments: I agree that physicians/health care providers’ time is pushed to the max. I have been visiting physician/health care facilities for the past 6 months, auditing patient charts and have seen first hand the pressures they face. I have also done auditing from both EHRs and from hand-written notes. The typed, electronic records make my job easy. The hand-written notes make it difficult. But, I agree with Marlene that physician offices are stretched financially, although from first-hand observations, many of them are overstaffed and could save money with less staff that is more productive. I have also worked in medical offices and know the difficulties of obtaining reimbursement, both from patients, Worker’s Compensation, automobile insurers and health insurance companies.

    I don’t agree with Marlene that the above-noted companies should be raked over the coals. Her statement, like many others who love to hate the insurance companies, is a broad generalization, with no statement of any facts or statistics to back up those statements. I suggest we all study the issues in greater detail before passing judgment on reimbursement companies, physicians, hospitals, etc.

  3. Shannon Helton, CPC says:

    I agree w/Marlene re. the insurance carriers. The basic objective of health insurance, if anyone can recall, is that it is supposed to assist people in affording their health care expenses by having people pay premiums into a pool of money that’s there when they need it (yes, we should all know this already, but I feel that we need to be reminded).
    The main objective of the health insurance industry nowadays is to turn as big a profit as possible by delaying & denying payment, making the reimbursement process as difficult as possible, and increasing patients’ out-of-pocket expenses.
    Health insurance is big business. A lot of people want to gripe & complain that physicians are overpaid, but how can they fail to notice the exorbitant salary United Healthcare’s CEO makes each year?
    Govt. wants to put the onus on health care providers to improve the system when what we really need to do is revamp our health insurance system so that it actually helps patients again.

  4. Harry Stuber, MD, COBGC says:

    I am one of the few physicians who adopted an EMR into my practice early (over 10 yrs ago). While the startup woes are way behind me, let me mention a few of the ongoing EMR problems. Computers only last a few years. We have replaced work stations, servers, monitors, UPS (universal power supply) units, printers and modems in a never-ending stream. Software updates are another cost we have to cover to maintain our “paperless office”. And instead of reaping any credit for early evolution to EMR, I am now worried that my system may not be compatable with whatever universal standard the government comes up with for electronic data exchange. Maybe I should have waited for others to work it out and. like the barnyard animals and the Little Red Hen, after all the work had been done, asked for my loaf of bread in 2009.

  5. Lynda says:

    I see both sides ot the EMR, I formally worked at a large teaching hospital in compliance who was in the process of adopting an EMR. There were many issues to overcome: who was documenting what, you know, all the issues with resident documentation, etc….And I am sure the cost was HUGE. And then there is the learning curve and constant training of staff and equipment purchases. On the positive side, it made records available to all the docs at the facility. On the negative side, it sure makes it easy for false documentation (cut & paste, macros), where as when handwritten it takes a lot more effort to write it all out, and most phys will not take the time. So possibly higher billable E&M visits.

    I currently work at a ruralish single physician private practice, there is no way an EMR is in our future unless someone else pays for it. Constant reduction in reimbursement from carriers is incredible. Having not been on this side for a long time, it has been quite enlightening and frustrating. But there is no money for this program being “forced” on us.

  6. Pawan Arya, MBA, CPC, CPC-H says:

    I agree with Marlene and others who think poorly of private carriers. From my experience of managing Oncology Practice for last 5 years, I know from first hand experience that there are carriers who pay for drugs like Medicare (which is dismal) and pay much less for the procedures.

    In my experience, Medicare is not the villain but it is the private carriers. Cost of doing business is more with Private Carriers because of maintaining networks, credentialing, keeping up with their policies, and denial for clean claims and holding on to money for more than necessary. Based on cost payment from Private carriers should be much more but comes no where near.

    If Private payers paid physicians appropriately, physicians will not be so hard pressed for resources and willing and able to afford technology and provide better quality of care.

  7. Heather Doughty says:

    The truth is: Physicians are people, CPC’s are people, and Insurance Companies are people, too.
    WE NEED MORE CARING AND RESPONSIBLE PEOPLE WORKING FOR THE INSURANCE COMPANIES!!!

    It amazes me every day how many patients (PEOPLE) would have to contact their insurance company and Primary Care Physician BEFORE they were even ALLOWED to be seen by a Specialist Physician!! That patient is there that day to RECEIVE A DIAGNOSIS on the condition they feel that they may possibly have. Most of the people that see a Physician are in pain somehow, and it is a ridiculous thought to make them wait in the lobby until we get it APPROVED by: not the Specialist physician, not only the Primary Care Physician, but also by the insurance company. Insurance Companies (people) are simply the ones deciding if WE (people) can cover that or not.

    People should read the CONTRACTS they have with the PEOPLE literally responsible for YOUR life. I assume some of these PEOPLE at the insurance companies believe that before you even go to the “Doctor” you are supposed to know exactly- what your insurance guidelines are going to allow you to have done that day to preventing the worse case scenario!

    Seriously Think about it!!

  8. Donna Nelson, CPC says:

    I agree with most of what I have read above, but, the physician is pushed for time, required by goverment to do more with less to do it with, and most if not all of the insurance companies are following suit of the goverment. In time past, 20 plus years ago, when I first started the medical field, the statement that Physicians were rich might have been correct, but now days they stuggle to pay there staff, even the ones that are not over staffed, provide for there families, pay over head cost of running a practise, such as supplies, utilities, and office space, which has all increased there cost, with no increase in what the physician get reimbursed. I agree that EMR is a good idea, and getting an incentive is great, but I’m sure the company that is supply the equipment, software, and training are not going to wait till you get your paymeny from the goverment, for you to pay them, so where is the up front money coming from, when the cost of every day over head is going up, and the reimbursement is not, something needs to change, and I feel that the physicians have been doing most of the changing lately, it is the insurance turn to suck it up, pay out what the people pay in, and stop taking million dollar bonuses for being a CEO.

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