Electronic Health Records Surge Despite Barriers

By Kimberly Ashton

Although Massachusetts has a head start on the national effort to digitize medical records, much work remains to be done before the state can meet President Barack Obama’s goal of having all health documents computerized by 2015.

The path ahead isn’t straightforward, and physicians must pay attention to the potential legal risks involved in using electronic health records (EHRs). A number of technological and financial hurdles stand between the government mandates and getting the nation’s medical system wired.

According to Kristina Barry, a spokeswoman for the state Office of Health and Human Services, 90 percent of private medical practices in Massachusetts are still not using EHRs. It can take years to select a vendor and set up electronic records in a typical medical office.
To meet deadlines and be eligible for incentives, physicians should start preparing now for the complete transition to electronic records, said James Bush, director of practice services at Massachusetts eHealth Collaborative.
“In order to qualify for incentives, providers really need to act now,” Bush said.
Incentive payments for physicians who implement EHR systems are scheduled to begin in 2011 for doctors who have EHRs that meet a “health information standard” and a “meaningful use standard,” neither of which has been defined yet, Bush said.
The Centers for Medicare and Medicaid Services (CMS) will be leading the formal rulemaking process to define “meaningful use standard” under the new law, according to discussions at a federal HIT Policy Committee in mid-June.

Failure to switch to EHRs won’t just result in missing out on funding. As of 2015, adoption of EHRs will be required for physicians to gain hospital licensure. And 2012 is the deadline for computerized physician order entry systems, Bush said.

The federal American Recovery and Reinvestment Act, passed Feb. 17, allocated nearly $20 billion for health information technology across the country. 
“We estimate approximately $500 million over five years in [federal] funding” will be given to Massachusetts, said Barry.

States are required to match $1 for every $10 provided in federal EHR implementation grants in 2011, $1 for every $7 in 2012, and $1 for every $3 in federal grants in 2013 and beyond.

In order to make sure the state has funds allocated to match the expected federal funds, the state Legislature in August allotted $25 million per year over the next seven years for adoption of health information technology. The amount was later cut to $15 million, with funding allocated only for one year.
Before the state doles out the money, the state’s nine-member Health Information Technology Council – which was appointed by Gov. Deval Patrick – must first decide how it will be distributed.

Attorney David Szabo, who sits on the council and is a partner at Nutter, McClennen & Fish in Boston, said the council will have control over allocating the state funds, but it’s still unclear what role it might play in doling out the federal money.
The council is now in the process of gathering feedback from health care providers, software engineers and other interested parties, and there is no date set to distribute the funds, according to Szabo.

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