Electronic Health Reporter

Perhaps creating an opportunity is nothing more than observing the details and taking action once one has been identified.

Lack of opportunity, on the other hand, might be the opposite – keeping your head down and barreling through life without taking an adequate measure of the terrain in which you are navigating.

The feds missed an opportunity. During their planning and roll out of meaningful use, in their effort to collect the health data of this country’s population, specialists, in many cases, were not considered as recipients of their meaningful use incentives.

For many specialties, this might not apply. But pediatrics are different entirely. Not so much for the physicians’ sake, but for the patients they serve.

Given the direct marketing plan that the federal government has undertaken with its latest healthcare pet project, Blue Button, I’m surprised by its lack of foresight related to patient involvement to this group when it comes to meaningful use.

As the feds work desperately to change the perception of electronic data collection, and to move the most information into electronic records as possible, one might think the best way to ensure absolute adoption is by requiring the one group of physicians who might be able to affect the longest term change to participate in the incentive program.

Pediatricians, like it or not, have not been given special treatment as far as meaningful use is concerned. They, like another large group of physicians, OBGYNs, are left to fend for themselves. You can read more about OBs and their fierce independence in my recent interview with digiChart’s CEO Phil Suiter. The reason is well known and obvious: these groups of caregivers don’t necessarily rely on the government (Medicare/Medicaid) to keep their doors open.

The nature of pediatric practice is such that Medicare is not a significant part of their practice so meaningful use incentives don’t apply here. Therefore, the only avenue left for pediatrics is the Medicaid option – and it only works for practices that have more than 20 percent of their volume as Medicaid. In most cases, these groups of physicians don’t meet the minimum requirements of serving Medicare and Medicaid recipients to qualify, and, also in most cases, they don’t go out of their way to do so.

Therefore, given the logic that A+B=C, they are not lining up to get their share of the incentive checks.

But, one would think the feds would try to find some way to make an exception for pediatricians to participate in meaningful use without having to meet the minimum requirement that 20 percent of their population participate in Medicare. I’m not trying to re-open an issue that I know has been discussed countless times; I’m trying to make a different point.

That is, given the new push for patient engagement and the social media-like approach being taken through the Blue Button movement, I believe the importance of pediatricians has been overlooked.

Why? Well, it’s obvious to me that to engage a population, it’s best to change the population’s behavior. To do so, you have to catch them young; so young that they never knew a difference otherwise.

For example, children today will never know what life was prior to the web. They won’t be able to imagine life before mobile devices turned us into an always on society. There’s a lot they’ll never know.

Thus, if they are exposed to electronic health records in their doctor’s office as they grow up, by the time they reach adulthood, they’ll expect their doctors to use nothing but electronic health records. In fact, they won’t even know what to do with a paper record – how to read and understand it – and, therefore, won’t give their money to doctors without the systems.

It’s really the most direct route to changing a population’s behavior.

Indoctrination.

Sure, engaging the adult population through a service like Blue Button is important, and will certainly help fill the gap currently experience in healthcare’s ownership issue, but as we’ve seen in every other area of life, true change won’t come until those who know no other way become the majority and know no other way.