IBJNews

Federal rule tied to electronic medical records panned

Back to TopCommentsE-mailPrintBookmark and Share

The federal government has erected a high fence around a pot of $27 billion available to doctors and hospitals that successfully computerize their patient records by next year.

That has sparked complaints around the country—including in Indiana—that the government’s standards are too difficult to meet so quickly.

“It was a typical first swing. It was ridiculous,” said Dr. Tim Story, a primary-care physician at Clarian North Medical Center in Carmel.

The rule was proposed Dec. 30 by the federal Centers for Medicare and Medicaid Services agency. The rule can be altered after a 60-day comment period and will then go into effect.

However, central Indiana doctors and, especially, hospitals have a bit of a leg up when it comes to meeting the hardest part of the rules: exchanging patient information with other health care providers.

That’s because hospitals here are sharing patient records through the Indiana Network for Patient Care, a database operated by Indianapolis-based Regenstrief Institute Inc. And doctors can receive lab reports and quality reports from services provided by the not-for-profit Indiana Health Information Exchange.

“Your physicians in Indianapolis are in better shape that way, because you do have an exchange,” said Wes Richel, an analyst for the Connecticut-based technology research firm Gartner. He supports the government’s high standard, but acknowledged it is a “stretch goal” that will be difficult to achieve.

Electronic swapping of patient records among hospitals and some physicians is occurring all over Indiana, including around Bloomington, Fort Wayne, Lawrenceburg and South Bend.

If those assets prove helpful, Indiana doctors and hospitals could have more success winning subsidies from the government to help defray the cost of their electronic medical record systems, or EMRs.

Those subsidies could reach as high as $44,000 from Medicare alone for each physician, if they are fully ready by 2011 or 2012. Physicians who join in later would receive smaller subsidies. In 2015, Medicare will begin reducing payments to doctors as a negative incentive to adopt electronic medical records.

For hospitals, the incentive payments will hinge on a complex formula based on their number and percentage of patients who pay with Medicare. For a very large hospital, which might have a third of its patients paying with Medicare, the subsidy could top $5 million over four years.

Larkin

In addition to swapping records, the federal government wants doctors and hospitals to be able to use their electronic medical record systems to prescribe drugs electronically, to track key medical conditions, to report quality scores to the Medicare and Medicaid programs, and to report surveillance data to public-health agencies.

Indiana hospitals and doctors still have plenty of work to do. The electronic sharing of patient records is mainly one-way so far, at least for physicians. They receive reports from hospitals and medical labs, but they don’t send out much information electronically.

They still rely on fax machines, mainly, for that function. Some use e-mail to swap records, but industry experts say it is not secure enough to ensure patient privacy.

“Very few providers currently are tapping into the INPC,” also known as the Indiana Network for Patient Care database, acknowledged Dr. Greg Larkin, chief medical officer at the Indiana Health Information Exchange. Because of that and other challenges, Indiana’s doctors have “only a potential leg up,” he added.•

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT

facebook - twitter on Facebook & Twitter

Follow on TwitterFollow IBJ on Facebook:
Follow on TwitterFollow IBJ's Tweets on these topics:
 
Subscribe to IBJ
  1. The $104K to CRC would go toward debts service on $486M of existing debt they already have from other things outside this project. Keystone buys the bonds for 3.8M from CRC, and CRC in turn pays for the parking and site work, and some time later CRC buys them back (with interest) from the projected annual property tax revenue from the entire TIF district (est. $415K / yr. from just this property, plus more from all the other property in the TIF district), which in theory would be about a 10-year term, give-or-take. CRC is basically betting on the future, that property values will increase, driving up the tax revenue to the limit of the annual increase cap on commercial property (I think that's 3%). It should be noted that Keystone can't print money (unlike the Federal Treasury) so commercial property tax can only come from consumers, in this case the apartment renters and consumers of the goods and services offered by the ground floor retailers, and employees in the form of lower non-mandatory compensation items, such as bonuses, benefits, 401K match, etc.

  2. $3B would hurt Lilly's bottom line if there were no insurance or Indemnity Agreement, but there is no way that large an award will be upheld on appeal. What's surprising is that the trial judge refused to reduce it. She must have thought there was evidence of a flagrant, unconscionable coverup and wanted to send a message.

  3. As a self-employed individual, I always saw outrageous price increases every year in a health insurance plan with preexisting condition costs -- something most employed groups never had to worry about. With spouse, I saw ALL Indiana "free market answer" plans' premiums raise 25%-45% each year.

  4. It's not who you chose to build it's how they build it. Architects and engineers decide how and what to use to build. builders just do the work. Architects & engineers still think the tarp over the escalators out at airport will hold for third time when it snows, ice storms.

  5. http://www.abcactionnews.com/news/duke-energy-customers-angry-about-money-for-nothing

ADVERTISEMENT