Medicare Compliance & Reimbursement

Care continuity an issue as smaller providers try to get on EHR train.

Further insight into the policy debate of health information technology appears in a Commonwealth Fund study reported in Health Affairs. Writing in "Functional Gaps in Attaining a National Health Information Network," researchers evaluated the impact of implementing the nation's HIT several years into the future.

The study concluded that financial and personnel constraints will cause smaller providers, such as home health agencies and skilled nursing facilities, to lag behind larger ones. Nevertheless, the study predicts that implementation of electronic health records and CPOE technologies will likely triple or quadruple in the next five years.

During that time period, investigators predict that administrative functionality, such as electronic claims submission and eligibility checks, will be most advanced, while clinical functionalities are likely to lag further behind. This gap, the report said, is due to the clear incentives for providers to adopt administrative capabilities, like reducing costs and decreasing turnaround time for bills.

EHR functionality will increase from 9 percent to 25 percent in small physician practices (one to four physicians), and from 15 percent to 38 percent in larger practices (more than 20 physicians). Computerized physician order-entry functionality will increase from 5 percent to 21 percent in small practices and from 9 percent to 32 percent in larger practices, according to the study.