On Eve of Election, EHR Debate Continues

Over the last 31 days leading up to the presidential election, we’ve seen tensions brewing between those who believe CMS’ “meaningful use” EHR incentive plan should be halted, and those who say it is changing the face of healthcare for the better.

In a response to the Oct. 4 letter to HHS Secretary Kathleen Sebelius penned by four Republican lawmakers who slammed the program on several counts - including failure to achieve interoperability - federally funded Regional Extension Centers (RECs) tasked with helping small practices adopt and implement EHRs defended the program.

In a press release issued Oct. 16, The Association of Regional Centers for Health Information Technology (ARCH-IT), the umbrella advocacy organization for the REC program, said that suspending the EHR program would be an “unfortunate development” at a time when the healthcare sector is poised to make some significant gains.

“Retracting or suspending the program would run completely [undermine the] federal commitment to HIT expansion,” said Jonathan M. Fuchs, FACHE of the Arkansas Foundation for Medical Care, and the president of ARCH-IT, in a press release. “But even more concerning is that it would financially damage the small practices that have already invested in an EHR and are currently working to achieve Meaningful Use.”

ARCH-IT noted that for the last 30 months, states, healthcare providers, health information exchanges, RECs, EHR vendors, and others have been working hard to help bring the national healthcare infrastructure into the 21st century, which is a more daunting task than “purchasing a new phone app.”

What’s especially concerning is mixed reports over whether the program will stay intact in a Romney presidency.

On the one hand, ONC chief Farzad Mostashari has noted how difficult it would be to take back the health IT program. During a question-and-answer session about the letter, Mostashari noted that healthcare organizations have made plans based on the EHR incentive. “This is a commitment that we cannot lightly pull back,” Mostashari said, adding that rescinding the program would require legislation that would have to pass both houses of Congress, and be signed by the president.

But at least a few healthcare experts seem to believe this is possible.  

Ed Daniels, consultant for health IT firm Point-of-Care Partners, wrote that, when it comes to health IT, were Romney elected, eventually, “Government incentive payments for EHR adoption likely will be dropped from future budgets.”

Meanwhile, studies touting the benefits of EHR use seem to be released every other day.

The latest:  A study from the Health Information Technology Collaborative reveals the use of EHRs is linked to significantly higher quality care.

The study, in which 466 private-practice physicians using either EHRs or paper records, assessed performance on nine specific quality measures, including eye exams, hemoglobin testing, cholesterol testing, renal function testing (for diabetic patients), colorectal cancer screening, Chlamydia screening, breast cancer screening, testing for children with sore throat, and treatment for children with upper respiratory infections. Overall, physicians using EHRs provided higher rates of needed care than physicians using paper, and for four measures in particular: hemoglobin testing in diabetes, breast cancer screening, Chlamydia screening, and colorectal cancer screening.

"We found that EHR use is associated with higher quality ambulatory care in a multi-payer community with concerted efforts to support EHR implementation,” authors concluded. “In contrast to several recent national and statewide studies, which found no effect of EHR use, this study's finding is consistent with national efforts to promote meaningful use of EHRs."