Health IT

The President’s Podium: Common Sense on EHRs

Posted in Board of Medicine, Electronic health records, Electronic Medical Records, Health IT, meaningful use on September 26th, 2014 by MMS Communications – 1 Comment

By Richard Pieters, M.D., President, Massachusetts Medical Society

In its landmark 2001 report,  Crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine recognized the “enormous potential” of technology to improve health care.  Indeed, of all the changes sweeping throughout healthcare in recent years, perhaps the most revolutionary has been health information technology (HIT).

One area of explosive growth within HIT has been electronic health records (EHRs). The U.S. Department of Health and Human Services noted in May of 2013 that the use of EHRs by doctors and hospitals more than doubled from the previous year, with Massachusetts one of the heaviest adopters.  Statistics from the Office of the National Coordinator for Health IT show that 71 percent of physicians and 80 percent of hospitals in the Commonwealth have adopted EHRs.

Yet, 14 years after the IOM’s report, after billions of dollars spent in federal incentives, and despite skyrocketing adoption, physician acceptance of EHRs appears at best, a mixed bag, at worst, a struggle. Recent efforts are instructive.

In its 2014 Survey of America’s Physicians released this month, The Physicians Foundation found that nearly half of respondents (45.8%) felt that EHRs “detracted from efficiency” and slightly more (47.1%) thought it “detracted from patient interaction.”  More than half (50.5%) believe EHRs “pose a risk to patient privacy.”

Separately, on September 16, the American Medical Association called for an overhaul of EHR systems. “Today’s current EHR products,” said AMA President-Elect Steven J. Sack, M.D., “are immature, costly, and are not well designed to improve clinical care…. The usability of EHRs is a significant driver of physician professional dissatisfaction and a challenge to practice sustainability.” AMA then outlined eight priorities for improving EHR usability to benefit caregivers and patients.

Frustration and dissatisfaction with electronic health records among physicians had surfaced well before the AMA pronouncement, and complaints about EHRs have been increasing as well. The inability of different systems to communicate easily with one another – the “interoperability” issue – remains a drawback.  Perhaps most unsettling, however, is the reality that hazards and risks remain, as the promise of widespread and reproducible gains in patient safety has yet to be fulfilled.

Here in Massachusetts, electronic health records have captured physicians’ attention for quite another reason.  Chapter 224, a law passed in August 2012 that outlined phase two of health care reform for the Commonwealth, included a provision that required physicians to demonstrate “meaningful use” proficiency (which only applies to Medicare and Medicaid) with EHRs as a condition of licensure.  That mandate is to become effective on January 1 of next year.  Without proper interpretation, the law as written could have had severe unintended consequences by disenfranchising over half of the state’s licensed physicians.

Now here’s the good news: The Board of Registration in Medicine has proposed regulations that include a broad set of exemptions for certain license categories.  The Board’s proposal also establishes multiple ways in which physicians could comply with the requirement.

The Board has posted its draft regulations and is accepting comments on them through Friday, October 3 at 5 p.m. MMS offered testimony in strong support of the proposals at the public hearing on Monday, September 29, and I encourage members to add their comments as well. Comments may be submitted via email to Eileen.Prebensen@state.ma.us All comments become public records and will be posted to the state’s website.

MMS has advocated on this issue since the law was passed two years ago, raising the specter of severe disruptions in physician practice and patient access to care.  We are now near a resolution that is advantageous to both physicians and patients.

The Board’s proposal, which addresses all of our major concerns, represents a reasonable, prudent approach to complying with the law, easing physician concerns, and maintaining access to care for patients.

While physician frustration with EHRs is high, it is important to distinguish between problems of technology and problems of policy.  Technological issues are likely to be worked out over time, if only by continued physician persistence and outcry for solutions, as demonstrated by the AMA.

Policy issues, as shown by the Board of Registration in Medicine’s common sense approach to fulfilling the requirements of Chapter 224, are more readily capable of resolution.

MMS, like the IOM, believes that electronic health records do indeed have “enormous potential” for patient care. Our extensive policy on EHRs declares support for them and a desire to work toward improving them, to capture “an opportunity for dramatic benefits to patients in clinical care, research, and the delivery of health care.”

Reaching that potential, however, will require the strong voice of physicians. Whether the issue is one of technology or policy, our local experience has shown how important it is that physicians participate in the conversation.  I urge you once again to review the draft regulations and send in your comments.

The President’s Podium appears periodically on the MMS Blog, offering Dr. Pieters’ commentary on a range of issues in health and medicine. 

EHR Next Chapter: A “Tool” in the MD’s Medical Arsenal

Posted in Electronic health records, Electronic Medical Records, Health IT on May 5th, 2014 by Erica Noonan – 2 Comments

data 2By Debra Beaulieu-Volk

Some of the Commonwealth’s premier experts in health information technology and electronic health records gathered recently at MMS headquarters to take part in the day-long continuing education event, Electronic Health Records Next Chapter: Best Practices, Checklists, and Guidelines.

“The EHR revolution is not new,” said Jeff Loughlin, project director of the Massachusetts eHealth Collaborative, while opening the morning session about EHR best practices and pitfalls. “Along the way, we have seen a lot of failures, primarily because a lot of expectations were put on the EHR to solve the problems of the medical practice,” he said, “rather than using the EHR as one other tool in your arsenal to improve work flow and provide better care.”

To help attendees make the most of this tool, physicians representing small, medium, and large practices weighed in on lessons learned from their EHR experience to date:

Don’t Fear Switching

Today, many physicians are deeply worried that the EHRs they adopted a decade ago no longer suit their needs, said Eugenia Marcus, MD, FAAP, pediatrician and chair of MMS Committee on Information Technology. She can relate, having learned and implemented three different EHR systems since beginning her quest for the paperless office in 1996. “Switching is not that hard,” she said. “Every word of the record does not need to carry over.”

During Marcus’ transitions, staff were responsible for making sure critical information, such as demographics and medication lists, was transferred immediately. But high school students to copy over the rest of the material over a long time period.

Use EHR to Improve Patient Satisfaction

EHRs do far more than simply house patient records, noted Hugh Taylor, MD, a family physician at an 11-doctor practice with three sites throughout the North Shore. In fact, out of the 17 functions Taylor listed that his EHR performed, the last four had little to do with practicing medicine.

“The EHR does many things that don’t affect the clinician so directly but are extremely important to how the office runs,” he said. Examples of these functions included scheduling, confirming insurance coverage, coding and billing, and tracking patient flow. That last item pulls double duty in Taylor’s offices, he said, by helping the practice inform patients when doctors are running behind and of how long they may have to wait. This data is also used to help the practice strive to improve its Press Ganey patient satisfaction scores, he said.

MDs Need Not Do All Documenting

Larry Garber, MD, and his team at Reliant Medical Group, where he serves as Medical Director of Informatics, pulled together a list of which individuals should do the documenting in the medical record, in order of preference, to promote optimal efficiency. “It doesn’t have to be just one person; it can be a combination of people,” he said.

The top choice of documenter, however, isn’t a person at all, but the computer itself. “Whenever possible, reuse data that you’ve already got,” he said. “Let the computer do as much work as it can.” (As a caveat to the pitfalls of copying and pasting, Garber noted that it’s a practice policy that physicians are responsible to review and update any information in notes they create.)

Next, Garber recommended letting patients populate some of their own data. Even triage nurses speaking with patients on the phone can contribute to the record, placing them in the third spot of preference. “What a great place to take history without tying up an exam room,” he said.

Rounding out the list of preferred documenters were medical assistants, doctors assisted by speech recognition, doctors assisted by transcriptionists, doctors typing, and scribes typing. When it comes to accuracy, Garber noted that physicians who use a combination of typing and speech recognition tend to produce the highest-quality notes.

More information about the event and links to faculty presentations are available online.

Free white paper for MMS members: “MMS Guide to Health Information Technology”

EHR Conference Speaker Emphasizes Importance of Protecting Patients’ Information

Posted in Electronic health records, Electronic Medical Records, Health IT, HIPAA on May 2nd, 2014 by MMS – Comments Off

By Vicki Ritterband

Ali Pabrai

Ali Pabrai

Encryption. Encryption. Encryption.

Those are the “three” most important activities doctors should do to protect the security of their patients’ electronic protected health information (ePHI), says cybersecurity expert Ali Pabrai, a  presenter at MMS’s recent conference, Electronic Health Records Next Chapter: Best Practices, Checklists and Guidelines.

Encryption is the conversion of data into a form that cannot be understood unless the reader has a key or password to unscramble the information. All sorts of electronic transmissions should be encrypted—including texts and emails—no matter what the device, said Pabrai. If data is encrypted, even if you have a security breach, it is protected.

“Unfortunately, application vendors in the healthcare industry have been lethargic about embedding encryption capabilities,” said Pabrai. “That makes it difficult for a practice or a healthcare organization to implement encryption.”

As more and health information moves between the cloud and mobile devices, organizations will increasingly need to focus their security efforts on those two areas, according to Pabrai. Healthcare data fetches a high price on the black market because it is so rich in identity information.

Cyber security attacks to all types of businesses are occurring at a breathtaking pace: the average organization experiences 1,400 attacks per week and of those attacks, approximately two accomplish their purpose, said Pabrai.  HIPAA fines for information security breaches can run into the hundreds of thousands and even millions of dollars. “Physician practices are more vulnerable to HIPAA fines than ever before,” said Pabrai. Often, organizations don’t know their systems have been broken into until months after the thieves have left the premises.

So what’s a practice to do? Here are the seven steps Pabrai suggests physicians take to ensure that their patients’ electronic protected health information (ePHI) is secure and complies with HIPAA regulations:

  • Assign someone in your practice to be the security or compliance officer. Make sure they have access to the appropriate resources to do their job.
  • Conduct risk analyses regularly, ideally on an annual basis.
  • Develop a security strategy and policies and document them. If HHS’s Office for Civil Rights investigates a security breach, the first thing they will ask is to look at your policies, said Pabrai.
  • Remediate when necessary: address any deficiencies in your protection strategy
  • Secure third parties: make sure your business associates are protecting your patients’ ePHI to the same degree you are.
  • Train your staff so they comply with your cyber security rules and regulations.
  • Evaluate your performance.

For an overview of what’s required from healthcare providers to comply with various aspects of the HIPAA Privacy and Security rules, the U.S. Department of Health & Services offers six free, CME-eligible online educational programs.

More information about the event and links to faculty presentations are available online.

Free white paper for MMS members: “MMS Guide to Health Information Technology”

Why Your Windows XP Computer Could Become a HIPAA Security Risk

Posted in Health IT, HIPAA, practice management on April 3rd, 2014 by MMS – 1 Comment

photo by stevendepolo via flickr.comIs your practice using computers that run Microsoft Windows XP? If so, you could be exposing your practice to security risks in the near future.

After April 8, Microsoft will stop supporting Windows XP, its venerable but aged operating system. This means that Microsoft will no longer send you regular software updates to correct new security holes and software bugs.

Will your XP computers suddenly become non-compliant? Not simply because Microsoft is withdrawing technical support. But without software regular patches, your computers may be increasingly vulnerable to the hackers and trolls who scour the internet. Usually they’re seeking credit card and bank account information, but if your system has security holes, they could access your patients’ protected health information more easily.

Will your computers continue to run on XP? If they’re functioning today, they probably will continue to function for a while. But many computer consultants are advising their clients to assess their risk and determine how they will modernize their systems.

Can I upgrade myself? Many computer users have tried upgrading to Windows 7 or 8 on their existing machines, but some have reported the process to be difficult, and sometimes a failure altogether. Many older machines simply don’t have the processing power or memory to run the newer versions of Windows. Sometimes the best solution is to get new hardware. Microsoft does offer brave, intrepid do-it-yourselfers  free data-transfer software.

Our advice? Talk to your computer vendor or consultant, and develop an upgrade plan. Granted, Microsoft derives commercial benefit from this decision, but security-sensitive users are left with little choice.You don’t necessarily have to upgrade today, but it’s not wise to delay the process indefinitely.

The President’s Podium: Mass. Medicine, After Cost Control

Posted in Board of Medicine, Electronic health records, Electronic Medical Records, Global Payments, Health IT, Health Policy, Health Reform, Regulation, Uncategorized on December 9th, 2013 by MMS Communications – 1 Comment

By Ronald Dunlap, M.D., President, Massachusetts Medical Society  

Massachusetts entered its second phase of reform with the 2012 passage of DSC_0003 Dunlap 4x6 color 300 ppi_editedChapter 224, cost control legislation officially titled “An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation.”

While the first phase, Chapter 54 passed in 2006, was indeed landmark legislation and served as the model for the Affordable Care Act, Chapter 224 alters the state’s health care industry perhaps like no other law.

The changes this law brings are vast, from payment reform to giving the Attorney General new powers in the health care marketplace. Although 224 does include some benefits for physicians (medical malpractice reform for one), other provisions pose significant challenges, particularly for physicians in small practices. Here are two that raise concern.

Health Information Technology (HIT) One of the biggest challenges presented by Chapter 224 is its embrace of health information technology. Physicians will be required – as a condition of licensure – to demonstrate proficiency in all aspects of health information technology by January 1, 2015.

While MMS supports HIT and recognizes its intent to improve patient care, this provision of the law could severely disrupt medical care. Because the statutory language creating the requirement is tied to Federal standards of “meaningful use” (which in turn is tied to participation in Medicare and Medicaid), it raises concerns that strict interpretation of this provision would lead to denial of license renewals for some 26,000 physicians.  Our state has a high certification rate for meaningful use, with more than 14,000 physicians having met stage 1 requirements, but nearly 40,000 physicians have a Massachusetts license, and most are not included in the population targeted for meaningful use certification.

Additionally, the costs of establishing HIT can be huge. The outlay for such items as implementation, maintenance, software and hardware upgrades, conversion to Federal ICD-10 codes, training, and data conversion could approach well over half a million dollars for some practices while not including the “opportunity loss of income” from decreased productivity.  While the law allows for assistance to providers for HIT, the level of help is unknown, and the financial burden can be crippling to small practices.

The law further requires all providers to implement fully interoperable electronic health records that connect to the statewide health information exchange by January 1, 2017 (a goal not in sight) and imposes penalties for noncompliance. These technologies are not only critical for physicians to practice medicine, but also to participate in quality measurement programs.  The specter of this kind of commitment to HIT, however, with its financial outlay, is certain to make physicians pause and think, especially those close to retirement.

MMS has had lengthy discussions with the Board of Registration in Medicine (responsible for implementing the HIT requirement) and has testified in support of legislation to delay this requirement and provide relief to physicians. Our voice has been heard, and we are hopeful such relief will be forthcoming.

Data Collection and Reporting Chapter 224 is equally enthusiastic about data collection and reporting.  It creates a “provider organization registration program,” requiring organizations to provide detailed information about their operations: costs, financial performance, utilization, total medical expenses, and patient referral practices, among other information.  This data is hard to extract from many EMR systems.

This information will be collected by the Center for Health Information and Analysis (CHIA), a new independent state agency created by 224 that takes over most of the responsibilities of the Division of Health Care Finance and Policy, which was abolished by the law. Physician groups are now required – for the first time – to submit such data. The law contains language focusing on the reporting on risk-bearing groups while exempting smaller groups, but the applicability of this language has not been fully tested yet, so it isn’t clear how reporting requirements will be enforced and upon whom.

On a promising note, CHIA Executive Director Aron Boros told our House of Delegates at the Interim Meeting on December 6 that CHIA’s goal is to gather “reliable and meaningful” information through an “engaged transparent operation.”  He believes his agency must be “transparent, open, and collaborative” to build credibility.

The law also stipulates that by January 1, providers must disclose to patients within two working days of their request, how much a proposed procedure or service costs and what the health plan offers as payment.

I am not optimistic that physicians will be prepared within a month’s time to inform patients about specific or estimated costs for all procedures. We are encouraging legislators and the Health Policy Commission to implement the law incrementally, by considering the most expensive procedures first.

HIT and data collection/reporting requirements are but two areas that Chapter 224 dramatically changes. These changes, coupled with constant concerns over Medicare reimbursements as well as added requirements such as those imposed by ICD-10 codes, continue to strain physician practices.

What policymakers and regulators must keep in mind is that, even in a highly sophisticated medical environment like Massachusetts, no less than 64 percent of our physicians are in practices with fewer than 25 physicians. Policies and regulations that burden these practices and reduce their viability will not only affect the quality of care but will also reduce health care access for Massachusetts residents.

The President’s Podium appears regularly on the MMS Blog, offering Dr. Dunlap’s commentary on a range of issues in health and medicine. For a section by section analysis of Chapter 224, click here.  

 

Annual Education Program: How Technology Is Improving Patient Care

Posted in Electronic health records, Health IT, medical homes on May 10th, 2013 by MMS Communications – Comments Off

From electronic health records to medical devices to the latest in research, technology is continuing to push into new frontiers in medicine, and that bodes well for patient care.

In introducing the 2013 Annual Education Program, Navigating the Currents of Change: Integrating Innovative Technologies Into Your Clinical Practice, MMS President Richard Aghababian, M.D. said “Incorporating technology into our approaches to patient care is one of the biggest challenges we face as physicians today. The tools and data we now have at our disposal are truly amazing. But we must balance the machines with the humans side of medicine.”

The educational program on Friday, May 10 included four distinguished clinicians and scientists who addressed concrete examples of how the latest technologies have made advances in the surveillance, diagnosis and management of disease, and how those technologies are being incorporated into patient care.

Dr. Robert L. Jesse, Principal Under Secretary of Health at the Department of Veterans Administration, discussed health information technology and how it affects patient care.

Dr. Marc Semigran, Medical Director of the Massachusetts General Hospital Heart Failure and Cardiac Transplant Program, talked about how technology and the latest medical devices are improving and extending the lives of patients with heart disease.

Dr. Suzanne  Topalian, Professor of Surgery and Oncology at Johns Hopkins School of Medicine, examined how nanotechnology and targeted immunotherapy are making progress in the battle against various forms of cancer.

Dr. John Moore, of MIT’s Media Lab, discussed the application of technology for patient empowerment within the medical home model.

The participants’ presentations, along with their biographical information, are available for viewing here.

 

Key Similarities and Differences Between the House and Senate Payment Reform Bills

Posted in Accountable Care Organizations, Defensive medicine, Electronic health records, Electronic Medical Records, Health IT, Health Reform, Malpractice, Mass. Legislature, medical liability reform, Payment Reform on June 8th, 2012 by MMS – 1 Comment

After two years of discussion and debate, the Massachusetts Legislature must now deal with two huge pieces of payment reform and cost control legislation.

Earlier this week, the House passed its legislation by a wide margin, following eight hours of deciding which of 275 amendments it would accept. The Senate passed a separate bill on May 17.

During the House debate this week, the MMS sought to protect most small and medium physician groups from the House’s very rigorous reporting requirements. The original House bill exempted groups with fewer than 10 physicians. Due to MMS advocacy, the House agreed to increase the exemption to 25, which we will try to increase further during the conference committee’s deliberations.

When the members of the conference committee are appointed, they will have until adjournment on July 31 to agree on a single bill and get it passed by both chambers.

Despite their many similarities, reconciliation and consolidation of the bills is not expected to be an easy task.

Key Similarities

  • Cost containment: Each bill states that overall health care costs should rise in concert with the growth in the state’s economy. (Differences noted below.)
  • State oversight: Each creates a new state agency to certify provider groups, and collect volumes of information on quality measures and costs. The House agency is placed inside the executive branch, under the Executive Office of Health and Human Services. The Senate agency is an independent entity.
  • Market power: Both bills require payers to negotiate separate contracts for each hospital facility, with some exceptions.
  • Alternative payment models: The bills define ACOs and their requirements. They provide a 2 percent bonus in Medicaid payments to providers starting in July 2013, if they move to alternative payment methodologies.
  • Electronic Health Records: Each requires physicians to be proficient in the use of electronic medical records. (Differences noted below.)
  • Medical liability: Both mandate waiting periods for civil suits brought against health care providers. They require disclosure of case information to patients and providers; protect statements of apology from being admissible as evidence; provide for early payments to patients without prejudice. They reduce the prejudgment interest rate in malpractice cases from 4 percent to 2 percent. No contract may prohibit a physician from serving as an expert witness.
  • Determination of Need: They expand the Determination of Need process to include more new technologies, transfers of ownership and site expansions.
  • Administrative simplification: Both bills require standards forms for utilization review.
  • Peer review: Both bills expand the peer review statute. The House specifically provides ACOs with peer review protection; the Senate provides such protections to any provider group that conducts peer review activities.
  • Charitable immunity: They raise the charitable immunity cap from $20,000 to $100,000 (affects most hospitals in Massachusetts).
  • Physician assistants and nurse practitioners: Each bill provides more independence to physician assistants and nurse practitioners.
  • Limited service clinics: Both bills eliminate some existing regulations for the operation limited service clinics, such as those located in pharmacies; however their approaches differ.

Key Differences

Cost Containment

  • The House’s benchmark is 3.6 percent for 2012 and 2013. In 2014 and 2015, it would be equal to the growth rate projected in the Governor’s budget submissions. From 2016 to 2026, it would be equal to a half percentage point below the Gross State Product (GSP) from 2016 to 2026, and equal to one point above GSP after 2027.
  • The Senate’s cost benchmark is a half point above GSP through 2015, and equal to GSP from 2016 to 2026.
  • The House imposes a penalty on providers who costs are 20 percent higher than the benchmark. It establishes rate setting for governmental units. The House gives the state the ability to force providers to reopen contracts that it considers contributing to excessive spending. The House gives the attorney general to block unreasonable increases in rates, and block changes that adversely affect patient access and the quality of care. In the Senate bill, groups that exceed the benchmark must file improvement plans.

Market power

  • The House subjects provider groups of 10 or more physicians to a market impact review.
  •  The Senate gives the attorney general the power to prevent excess consolidation and collusion.

Certification

  • The House requires any physician group with 25 or more physicians to be certified by the Department of Public Health.
  • The Senate requires certification for all providers entering into alternative contracts. It exempts groups with less than $500,000 in annual net patient service revenue and fewer than five affiliated physicians, if the group does not accept risk.

Electronic Health Records

  • The House requires providers to adopt EHRs that are fully interoperable and connect to the statewide health information exchange.
  • The Senate updates existing the requirement for EHR proficiency by 2015 by requiring physicians must demonstrate the skills to comply with the federal government’s meaningful use requirements. It creates an institute to facilitate the implementation of interoperable records statewide, and promote the use of other health information technologies.

Data Tracking and Analytics: No Longer Avoidable in Physician Practices

Posted in Accountable Care Organizations, Electronic health records, Health IT, meaningful use on March 29th, 2012 by MMS – Comments Off

In an age where the federal government has settled on a total of 33 quality metrics in its final rule for accountable care organizations, figuring out how to track data and meet quality and performance benchmarks is becoming a critical part of a physician’s role in providing quality care to patients.

More practices in Massachusetts are focusing on data and analytics, because where risk-based contracts and accountable care delivery models are becoming increasingly prevalent. Understanding practice level and physician level data is a key to success, starting at the point of payer contract negotiation.

Many practices are challenged by where to start, which is not surprising given the alphabet soup that exists in terms of recognized metrics, HEDIS, NQF, NCQA, PQRI, PCPI to name only a few.

The good news is that while many are just beginning on this path, several practices have been operating in the data and analytics space for many years, and they are happy to share their lessons learned as well as the upside and downside of their experiences.

One such practice, South East Texas Medical Associates (SETMA), under the leadership of Dr. Larry Holly,  has worked to hone its data analytic capabilities to successfully manage their patient population, and has demonstrated success in improving metrics in areas such as diabetes management.

Of course, this is the result of years of evolution and a level of comfort with the metrics that are being tracked. That being said, SETMA has demonstrated success in working with the plans in risk based contracts as a result of their efforts.

Again, it took years for SETMA to perfect its strategy. One should not fear data tracking and analysis but embrace the initiative by starting with a few metrics that are important to the practice.  There is plenty of opportunity to tweak, improve and revise your processes over time.

As experienced practices such as SETMA will tell you, it’s about starting somewhere and perfecting your process over time.  On that note, why not start now?

If you’d like to learn more about how to approach data and how organizations like SETMA were able to successfully use data, join us at MMS on March 30th for the program titled “The Importance of Data in Physician Practice”.  Visit http://www.massmed.org/DataAnalytics2012
– Kerry Ann Hayon

CMS to Delay ICD-10 Implementation

Posted in Electronic Medical Records, Health IT on February 14th, 2012 by Erica Noonan – 6 Comments

The acting administrator of the Centers for Medicare and Medicaid Services said today  her agency may delay adoption of a complex new insurance coding system.

Speaking at a conference of the American Medical Association on Tuesday, Marilyn Tavenner (right) said CMS is considering giving the nation’s doctors more time to switch to the ICD-10 systems.  Currently, the law requires implementation by October 2013.

(UPDATE: On Feb. 16, the CMS formally announced an indefinite postponement of the deadline to comply with the ICD-10 system.)

“I’m committing today to work with you to reexamine the pace at which we implement ICD-10,” Tavenner said to loud applause from hundreds of physicians. “I want to work together to ensure that we implement ICD-10 in a way that (meets its) goals while recognizing your concerns.”

Proponents say the switch from ICD-9 to ICD-10 will bring the U.S. medical system in line with much of the rest of the world, while allowing health officials to better track the nation’s health and monitor diseases.  The new system has some 68,000 codes, five times the amount under the current system.

The AMA and other physician groups say switching to ICD-10 coding will cost medical practices anywhere between $83,290 and more than $2.7 million, and that the pressure is too much while physicians are also coping with complex new electronic health record requirement mandates.

Lynda Young, M.D., president of the Massachusetts Medical Society, praised Tavenner’s openness to delaying ICD-10 implementation.

“This is a good thing, and it will give us more time to get ready,” said Dr. Young. “There are serious time and cost issues for practices trying to implement all of these changes at once.  We want to give people a chance to take care of the other changes first.”

Tavenner said her office would formally announce its intention to craft new regulations within the next few days.

More on the CMS announcement:

Erica Noonan

New England CMS Director Says Physicians Must Adapt

Posted in Electronic health records, Electronic Medical Records, Health IT on January 17th, 2011 by MMS – 1 Comment

The “dizzying” pace of change in our health care system requires physicians to adapt quickly to this new world, says chief medical office of CMS’ New England Region, Dr. William Kassler.

Speaking at the Massachusetts Medical Society’s health IT conference on Friday, Dr. Kassler began his remarks by outlining the impressive breadth of innovation occurring at the national level.

He then told physicians in the audience that the only way to take advantage of these innovations is to embrace information technology.

Later, in response to a question about whether physicians should wait to adopt EHRs until interoperable health information exchanges become a reality, Dr. Kassler said, “I reject the idea that you need a fully functional EHR to get the benefits.” He said the benefits from the decision-support tools in a freestanding EHR is “reason enough to invest.”