Have you ever sought medical care from multiple providers for the same condition? Then you probably already know how difficult it can be to coordinate care from one practice or facility to the next. One provider may not necessarily have access to the test results ordered by another provider, and even getting a prescription filled can be a hassle — you have to wait while the pharmacist fills your prescription and hope that he or she doesn’t misread the prescribing doctor’s terrible handwriting.
But all of that is changing; for many patients across the country, it has already changed, thanks to the Health Information Technology for Clinical Health (HITECH) Act of 2009. This law was enacted to encourage the transition to electronic health records (EHRs) in medical practices, hospitals, and other health facilities. Researchers agree that the use of EHRs can have many benefits for providers and patients alike, including improved patient outcomes, reduced costs, streamlined administration, and even improved ability to perform medical research.
What Are EHRs?
An EHR is an electronic record of a patient’s medical history that combines test results, diagnoses, and other data accumulated as the patient moves from one provider to another. Your EHR is meant to be longitudinal in nature, meaning that the record represents a lifetime picture of your health history.
Unlike a medical record, which is maintained by a single provider, an EHR is comprehensive; since it includes information compiled from every provider who works with you, it will offer each provider all of the information necessary to make your next treatment decision. That means no more re-ordering an expensive test you’ve already taken somewhere else, and no more waiting for test results to be faxed over from another doctor’s office.
Advantages of EHRs
Ideally, EHRs will someday travel with you. When all providers have made the transition to using EHR systems such as RevenueXL, you’ll be able to get the same quality of care from providers anywhere in the country. They’ll simply be able to check your EHR for pertinent medical information, and even update it so that your providers back home will be able to adjust your care accordingly. Even if you’re incapacitated, your EHR will ensure that providers around the country will be alerted to your medication list and existing medical conditions.
EHRs should make life easier for everyone involved in your care. You’ll be able to:
Schedule doctor’s appointments online
Ask medical questions via email
Request prescription refills electronically
Access test results whenever you want
Keep track of scheduled appointments
The use of EHRs should streamline the many administrative tasks associated with patient care. EHR system software will prompt your doctor to file necessary Medicare and insurance paperwork, will help them keep track of which best practice guidelines apply to your specific case, and will reduce numerous costs.
With a flourish of congressional shenanigans lifted almost word for word from the teleplay of Netflix’s House of Cards, the HHS-mandated 2014 transition to use of the ICD-10 coding classification was brought to a screeching one year “delay.” We are left, once again, with “at least” another year of collecting healthcare information via ICD-9, an awful but omnipresent healthcare coding system. And more concerning, we are left with the impression that diligent and expensive work to comply with rules in a host of other areas, such as meaningful use of electronic health records, could become abruptly irrelevant. The result of the delay is that not only do we have a significant number of long-time objectors to the change to ICD-10, but they are also joined by a surge of rightfully angry and dubious ‘compliers’ who put in time and investment dollars to meet the deadline. But there are also some additional considerations given the amount of time that has passed as we prepare to make the trip.
Is this trip still worth the aggravation and expense?
The major underlying rationale of moving to ICD-10 remains laudable: to provide greater clarity to our understanding of healthcare practices through the use of better industry standard, diagnosis codes. With more granular, relevant and precise core codes at the foundation, medical quality and effectiveness studies utilizing these codes for analysis and program development were to have benefitted dramatically.
Given that our desire to advance healthcare value and improve outcomes through accountable care practices (‘fee-for-value’) we must acknowledge our dependence on much better information collection for analysis than is possible from ICD-9. Significant questions remain however, as to whether the move to ICD-10, using codes predominantly still entrenched to support fee-for-service billing processes will get us where we want to go. While we can hope the enhanced and detailed nature of ICD-10 might yield greater insight into the real value of our activities, this remains a particularly frail hope in light of the way we use the codes as revenue cycle fuel.
Guest post by Andy Nieto, health IT strategist, DataMotion.
The HITECH Act’s goal of improving clinical outcomes for patients using technology through meaningful use is admirable and quite overdue. However, where the Office of the National Coordinator for Health Information Technology (ONC), and to a much greater extent, electronic health records (EHR), have missed the mark is in the deployment and execution.
The stated goal of meaningful use Stage 1 (MU1) was to deploy, integrate and use EHRs to gather and document “structured and coded” healthcare data. Rather than take ONC’s directives as a framework to improve provider care tools, they viewed it as a “minimum requirement” and missed the spirit of the initiative. EHRs remain cumbersome, challenging and inefficient.
Providers now spend more time clicking boxes and typing than they do speaking to their patients. To make matters worse, the data gathered is maintained in the EHR’s “unique” way, making exchange and interaction challenging and interfaces costly.