In an effort to increase the use of electronic health records by doctors, hospitals, and other health care providers, Congress passed the Health Information Technology for Economic and Clinical Health Act, more often known as the HITECH Act, in 2009. The law provided both incentives and penalties to encourage widespread adoption, but so far many hospitals and doctors have failed to comply.
On December 17, 2014, the Centers for Medicare and Medicaid Services (CMS) announced 257,000 doctors had failed to achieve what it termed “meaningful use” of electronic health records, and would have payments for Medicare services reduced by 1 percent as of January 1, 2015.
According to the American Medical Association, that is more than half of all doctors covered under the HITECH act.
Dr. Joe Bentivegna of Rocky Hill, Connecticut says electronic health records are expensive and impractical.
“Doctors struggle because the user interfaces are slow and there are too many questions,” Bentivegna said. “It works poorly with ophthalmology, my profession.”
Incentives and Penalties
Early on the HITECH act provided taxpayer funds to medical providers to help pay for the adoption of electronic health records. Those incentives will remain through 2016, but penalties have also kicked in for those who haven’t satisfied the CMS meaningful use requirement. The 1 percent reduction in 2015 will rise to 5 percent over five years, taking a significant bite out of many doctors’ revenue.
Dr. Stephen Stack, president-elect of the American Medical Association, expressed dismay over the news 257,000 doctors would be penalized in 2015.
“The Meaningful Use program was intended to increase physician use of technology to help improve care and efficiency,” Stack said in a statement. “Unfortunately, the strict set of one-size-fits-all requirements is failing physicians and their patients.”
Stack charged the meaningful use requirements “are hindering participation in the program, forcing physicians to purchase expensive electronic health records with poor usability that disrupts workflow, creates significant frustrations and interferes with patient care, and imposes an administrative burden.”Increasing Government Control
Twila Brase, president of the Citizens’ Council for Health Freedom, sees the meaningful use requirements as a backdoor way for the government to play a heavier role in directly controlling medical care.
“So if you want to control the entire health care system, what do you need?” Brase asked rhetorically. “You need to know what the doctors are doing, you need to decide what you want them to be doing, and then you need a system to record how far they are removed from what you want them to be doing to that you can financially penalize them.”
Brase expressed concern the electronic health records created in compliance with the HITECH Act will be used to ration care, pointing to comments by controversial MIT economist Jonathan Gruber.
“Gruber says they only want people to get the right care for the right things,” Brase explained. “They’ll sometimes talk about ‘right place, right time, right patient, right care,’ as though we were all sort of widgets in the system. Their plan is to use all of our data to standardize the practice of medicine, to put those standardized treatment protocols on the electronic health system, and nothing else.”