The American Recovery and Reinvestment Act of 2009 provides physician practices, clinics and hospitals with the carrot of financial incentives for implementing electronic and personal health records (EHR and PHR, respectively) -- and the stick of dwindling Medicare reimbursements for those who don’t.
The big disincentive for EHR adoption may not turn out to be finance but rather the complexity of the job.
Health care providers are now starting to understand just how difficult it will be, as they sift through the discrete data silos containing the different bits of information the Office of the National Coordinator for Health Information Technology requires to satisfy meaningful use rules and, ultimately, financial benefits.
But experts presenting Feb. 9-10 at the Boston Healthcare Stimulus Exchange said that patients may drive EHR adoption as they learn more about the benefits of electronic health records and having lifelong PHRs accessible to every physician and specialist they see -- not to mention accessible for themselves on the Web. While the government’s carrot-and-stick approach may provide a little motivation, the fear of losing patients to more technologically sophisticated providers may push them much harder.
“[Health care] is a $2.1 trillion industry that is being updated,” said Vish Sankaran, director for the Federal Health Architecture Program, calling for consumer engagement in health care IT. “The big [opportunity] that isn’t being explored enough is consumers. … We want to make it better for each and every one in this country. They badly need our help. The patient is waiting.”
EHR adoption slow, under construction
Consumers can already access their PHRs through some patient portals providers have set up on websites. Some hospitals, including Beth Israel Deaconess Medical Center in Boston, also have connected health records to Google Health and Microsoft HealthVault, in addition to Beth Israel’s own PatientSite. These services give patients access to their full medical history, including medications, allergies and notes from doctors’ visits.
Beth Israel CIO John Halamka noted that, while Google and Microsoft are not business associates or covered entities, they nonetheless “provide value because they allow you to aggregate data from [places such as] Qwest Labs, CVS and other pharmacies and hospitals into one place where you can manage it.”
Other organizations, such as the American Health Information Management Association,offer consumers step-by-step instructions for creating their own PHRs, complete with advice on securing and storing data.
Educating consumers about PHR safety
Getting consumers on board requires a two-part education effort. First, providers will have to show their patients what they are making available and how it can be accessed as the various parts of their PHRs go online.
The big [opportunity] that isn’t being explored enough is consumers. … We want to make it better for each and every one in this country. They badly need
Vish Sankaran, Director, Federal Health Architecture Program
Then comes what may prove to be a more difficult proposition -- convincing the public that a facility has secured its patient data, as well as acquiring patient consents to share it among entities covered by the Health Insurance Portability and Accountability Act (HIPAA). As new data breach notification rules bring more incidents to light, consumers are becoming aware of the identity-theft risks involved in this new era of EHR adoption. Having names as recognizable as Google and Microsoft involved could help raise awareness, but will consumers trust them to not use data in their PHRs for marketing purposes?
Explaining security in terms consumers can understand may be the key to getting them involved, show attendee Jennie Chiller, health IT adoption manager for the Rhode Island Quality Institute, told SearchHealthIT.com.
Rhode Island assembled a consumer advisory committee to understand and address fears and to identify potential issues involved with health information exchange, she said.
“It’s sort of like when we started using ATMs,” Chiller said. “It’s just technology and trusting that your data’s going to be safe when you put your debit card into the machine -- that’s why educating consumers is so critical. If we can help them understand what HIPAA … and protected health information [are], and how we are protecting their health information, I think they’ll feel comfortable. We need to not only market to clinicians, but also to consumers.”
Let us know what you think about the story; email Don Fluckinger, Features Writer.