Thursday, October 11, 2012

Here Is Yet More Fuel To The Value Of Health IT Fire. It Is Not Easy To Sort Out Fact and Fiction.

The following appeared a little while ago.

EHR Savings Debate Grows

Credible sources are raising serious concerns about the value of health IT. Some, but not all, of their criticism is warranted.
The last two weeks haven't been kind to the vendors and users of electronic health records.
A recent column in The Wall Street Journal challenged the notion that EHRs are reducing healthcare costs, citing data from an exhaustive scientific review of 36,000 studies on the subject. Description: AdTech Ad
Similarly, the Center for Public Integrity, an investigative news organization, last week posted an article saying that healthcare providers may be inappropriately using EHRs to justify higher evaluation and management (E&M) coding levels, a practice it maintains is costing Medicare billions of dollars a year. The article, by Fred Schulte, charges that federal officials, because they were intent on increasing adoption of EHRs, ignored warnings that the systems could help physicians raise coding levels.
The core of the allegations is that EHRs let doctors copy and paste findings from previous notes into current notes, providing documentation that can be used to justify higher coding levels. In a letter sent last week to major national medical organizations, U.S. Department of Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder stated: "There are troubling indications that some providers are using [EHR] technology to game the system, possibly to obtain payments to which they are not entitled."
These accusations echo concerns I've had over the last year or so. When I first signed on as editor of InformationWeek Healthcare in 2011, I expressed guarded optimism about EHRs, guarded in part because "with so much money in play, I'm sure some hospitals and group practices will try to game the system--with taxpayers and patients picking up the bill."
Just last week I posted a column about accountable care organizations, in which I wrote again about the risk of upcoding and gaming the system. In that column I discussed the shaky research foundation on which ACOs are based: pilot projects that likewise used "creative medical coding" to justify their cost savings.
Lots more is found in the link in the text.
This is a useful collection of articles and references.
This is a debate all those who have an interest in avoiding waste and making sure that e-Health delivers what is hope for need to stay very much on top of. It will only take a few enthusiastic budget cutters, after the next election, to decide e-Health is dispensable, and we will see the ‘baby go out with the bathwater’.
That would be a very great pity.
David.

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