The HITECH section of the 2009 Stimulus Act provides almost $18 billion to reimburse physicians for adopting electronic medical record (EMR) systems, and $1.2 billion to subsidize creation of a health information network in each state that electronically links the care provider systems within each state.
To qualify for reimbursement, physicians must install an EMR system and meet Meaningful Use criteria. In return, the government will reimburse them up to $44 thousand per physician, to be paid over three years starting in 2011. If they do not install an EMR system and meet the three stages of Meaningful Use requirements by 2015, their Medicare reimbursement rates will be reduced.
While HITECH is raising every physician’s awareness of the need to have electronic medical records by 2015, it also is provoking a growing rebellion. Paper-using physicians are very aware of the traumatic experiences many colleagues have had installing legacy EMR systems. As a result, many are seriously considering not participating in the reimbursement program and—starting in 2015—opting out of Medicare. Moreover, many practices that previously installed EMR systems are abandoning them as too costly and too cumbersome.
Such resistance may force the government to extend its adoption and reimbursement deadlines. And if enough docs drag their feet or refuse to adopt EMR systems, state and federal efforts to network care provider EMR systems will stall as well.
Despite these possible problems and in part because of them, we believe the massive infusion of government funding will have a very favorable impact on the patient-focused MedKaz.
Most docs would like to have a simple EMR system that is easy to use, saves them money and enables them to keep and access their patient records electronically. That’s precisely what our Patient Record Manager (PRM) does. The legacy systems the government is urging physicians to adopt, do not.
Even the simplest legacy systems typically cost far more than the mere cost of the EMR software. Their installation seriously disrupts the doc’s work flow and requires expensive additional hardware, software, and staff training. Most importantly, while the docs and their staffs learn how to use the system, which typically takes six to nine months, they must reduce the number of patients they see each day by up to 50%. One four-doc practice in VT paid $40,000 for their EMR system but estimates their all-in cost totaled $316,000. Others have had similar experiences.
In contrast, the MedKaz System benefits paper-using physicians in three important ways. It actually increases their revenue. They are paid for uploading a patient’s records following an encounter. It does not disrupt their work flow. And its PRM serves as an EMR-lite, meeting their desire to have a manageable, low cost, easy to use electronic system even while keeping paper charts.
A copy of the digitized paper records already loaded onto the patient’s MedKaz, is automatically downloaded onto his or her PRM. So now the doc has a manageable digitized copy of the paper records he or she has created for each patient. The next time the patient comes for an appointment, the doc can open his or her PRM and review the patient’s chart on their computer rather than having to pull the patient’s paper chart.
Additionally, the MedKaz makes it possible for docs to meet important Meaningful Use requirements. For example, by loading a patient’s encounter record on the patient’s MedKaz, the doc satisfies the requirement that the physician must be able to give his or her patient an electronic copy of their encounter record. In turn, the patient can access the record and share it with his or her other care providers.
The PRM also enables paper-using docs to meet certain public health needs. If there is a drug recall, they can electronically identify which of their patients take the drug. Or if they need to contact patients with a particular illness, they can easily do so.
Thus, the PRM satisfies the needs docs have for electronic records even if they keep paper records. Adding to its appeal, it is free, easy to use, and doesn’t disrupt the doc’s work flow or force them to reduce the number of patients they see.
Once paper-using physicians learn how convenient it is to use electronic records, we believe and hope they will opt to install a more robust EMR system, though their choices may be quite different from today’s legacy systems. And when they do, they will avoid the cost of having to scan and digitize their active patient records. They’ll merely upload their records from their PRM to their new system.
Thus, the patient-focused MedKaz and physician-focused EMRs will live side by side-with each meeting the unique needs of its owner. The MedKaz will continue to meet patients’ needs to own and control their medical records, make them immediately available to care providers when and where they need care, and facilitate the coordination of their care. And EMR systems will meet the record-keeping, practice management and public health needs of physicians.