Meaningful use incentives are improving adoption of electronic health records among small physician practices, but meaningful use itself is blocking further development of EHRs, which raises new barriers to adoption. That's what the CEO of a major health information technology vendor told members of Congress on June 2.
Andrew Slavitt, CEO at OptumInsight (formerly Ingenix), spoke before the House Committee on Small Business' subcommittee on healthcare and technology on the issue of health I.T. barriers.
"Physicians will point to several barriers to adoption including costs, legal uncertainty, privacy regulations and additional regulatory requirements regarding the use of technology," Slavitt noted. "But the greatest barrier is that the decision support and productivity-enhancing capabilities that allow technology to solve simple problems such as connectivity, prioritization and workflow improvement are not driving the purchase and design of technology. They have taken a back burner to all of the compliance reporting requirements needed to demonstrate Meaningful Use and qualify for HITECH Act incentive payments."
And as long as meaningful use is the priority, improving user-friendly and productivity capabilities of EHRs will suffer, Slavitt noted.
"As long as EHRs are designed principally around a set of needs in Washington and at the Centers for Medicare and Medicaid Services, it is a long-shot that the technology will provide the simplicity and productivity benefits at the heart of driving real adoption. Whether Meaningful Use standards are right or wrong is not the real issue. What is important is that today, the end users, doctors and patients, are further away than ever from system design, because new product development is focused on satisfying those regulatory hurdles, rather than on simple innovations that improve productivity. As a result, program requirements are disruptive to the processes in place in increasingly busy offices."
Slavitt offered five recommendations to subcommittee members:
* Congress has a responsibility to conduct oversight of the meaningful use program to prevent practice disruption and the administration should simplify and align incentives across multiple programs;
* Continue federal investments in health information exchanges, which should be as essential to CMS as its Medicaid management information systems that pay claims and administer benefits;
* Reduce uncertainty over the legal environment, as some physicians may fear that technology will become a basis for legal discovery and potential lawsuits;
* Provide small business benefits for small physician practices, such as Small Business Administration loan guarantees to ease access to capital for I.T. investments; and
* Shorten and improve the feedback structure so government isn't afraid to abandon policies that aren't working, while continuing to support those that work. Congress, for instance, should continue to support the regional extension centers program.
Testimony from Slavitt and other witnesses is available here.
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