News that US regulators are softening some of their EHR requirements is bringing mixed reviews from physicians and patients, who seem divided on the issue.
The Affordable Care Act is undoubtedly one of the most controversial pieces of legislation to hit the United States in decades, if not ever.
As a Canadian who grew up with universal health care here in Canada, I am watching the debate in the US with great interest as politicians, regulators, lobbyists, patients and physicians struggle to make sense of this game-changing approach to health care.
EHR on the table
One of the most talked-about aspects of the legislation is the requirement that physicians switch from paper to Electronic Health Records. Doctors received some $28 million in funding back in 2011 to make the switch, which was supposed to make their jobs easier, not more difficult. It was also supposed to empower patients and make interoperability between health care institutions possible.
Patients laud the move while some physicians are pushing back, saying EHRs will increase their already ridiculous workloads. Other physicians say EHRs make their jobs easier.
Who to believe
According to a recent post I read in the Courier-Journal and USA Today, “a series of new rules proposed by the U.S. Department of Health and Human Services would extend the time doctors, hospitals and tech companies have to meet electronic records requirements, slashes how much data they have to collect and reduces how many patients have to access their own electronic records from five percent to just one person.”
Patients say yes
Some patients, like patient advocate Regina Holliday, are criticizing the change saying it’s a “slap in the face” against everything they’ve worked for while physicians such as Dr. Charles Kodner, a family physician in Louisville, says "I don't think anyone thinks [EHRs] improve patient care at this point. And everyone feels that EHR are slowing them down."
Not so much, say some doctors
The article goes on to quote family physician Dr. Praveen Arla who said even though he's "one of the most tech-savvy people you're ever going to meet," his practice has struggled with its EHR system. He said the system cost hundreds of thousands of dollars to put into place and "doesn't even connect with other systems in hospitals and elsewhere."
Dr. Arla said the federal government should have “really looked at this more closely when EMRs were implemented. Now, you have a patchwork of EMR systems. There's zero communication between EMR systems. I am really glad they're trying to look back and slow this down."
The good news is that US Sen. Lamar Alexander, R-Tenn., chairman of the Senate health committee, and Sen. Patty Murray, D-Wash., announced a “bipartisan electronic health records working group” last month to help doctors and hospitals “improve quality, safety and privacy” to facilitate electronic record exchange among health care providers and different records vendors.
At a Senate appropriations subcommittee meeting held last month, Alexander told HHS Secretary Sylvia Burwell that "addressing electronic health records issues should be at the top of his committee's and HHS' priority lists".
In a news release from the committee, Alexander also said “that the ‘failed promise’ of the $28 billion electronic health records program "may stand in the way of a precision medicine initiative until physicians are able to use systems that communicate with one another."
We’ve got to get these records to a place where the systems can talk to one another – that’s called interoperability – and also where more doctors, particularly the smaller physicians’ offices, want to adopt these systems, can afford the cost, and can be confident that their investment will be of value. - US Sen. Lamar Alexander, R-Tenn., chairman of the Senate health committee
Meanwhile, Minnesota has become the latest state to allow some health care providers to opt out of using electronic health records.
Where do we go from here?
As I have always said, medicine is part art, part science. No two physicians will practice medicine the same, despite protocols from their regulating bodies. What sets them apart from each other, beyond the mandatories, is their age, experience level, training, personal preference and desire to adopt change.
For many, regardless of age, technology such as the EHR presents an entirely new set of protocols / challenges.
Whether or not physicians adopt these EHR protocols ultimately depends on how hard the US government wants to crack down. And if EHR adoption is eventually ruled mandatory, despite this most recent regulatory slowdown, physicians will have no choice but to "get with the program."
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.