When two opposing forces collide, the results can be devastating. Last week Hurricane Sandy -- a warm air, warm-water storm moving up from the south -- met up with a bitterly cold nor'easter, creating a monster storm that battered the East Coast.
On the eve of the presidential election, healthcare leaders cannot help but wonder if the industry facing its own perfect storm.
Obama's administration gave us the HITECH legislation, enacted to accelerate the federal initiative for adoption of certified electronic health record technology (CEHRT) while allowing healthcare providers and hospitals to receive incentive payments for its adoption.
So what happens to HITECH and CEHRT after the 2012 election?
It’s reasonable to expect the program and CEHRT incentives to move forward if Obama were to be re-elected. But what happens under a Romney administration? Although Romney has stated he would repeal and replace the Affordable Care Act, this alone would not affect CEHRT adoption incentives as they are part of the HITECH Act. In the “Believe in America, Mitt Romney’s Plan for Jobs and Economic Growth” publication, however, there is a key policy proposal statement that could affect HITECH and much more. Policy proposal 13 states that a Romney administration would “[i]nitiate review and elimination of all Obama-era regulations that unduly burden the economy” [p. 61 & p. 154, 2011]. Could the HITECH act fall within this proposed regulation if Romney were elected? Is adopting CEHRT an economic burden? Could HITECH be repealed? What would be the impact?
To answer these questions, it’s important to understand the effect of adopting standard electronic healthcare records (EHRs) on the economy as well as patient care. Is it a burden or a blessing? The healthcare industry is in its infancy regarding meaningful use regulations for CEHRT. The industry needs time to determine exactly how CEHRT can improve performance, the quality of patient care and result in better clinical outcome data all while reducing costs.
Simply using CEHRT does not translate into benefits. Like anything else, success depends upon execution. Using a computer and word processing application, for example, does not automatically make anyone a better writer. Used in an efficient and effective manner, however, these tools do save time and reduce errors. The author can also post the computer paper electronically to reach a much wider audience with no geographic boundaries. Similarly, it isn’t a question of whether CEHRT can achieve better patient care by saving record-keeping time and reducing errors while sharing information easily in an appropriate manner; it’s just a question of how and when.
What about the economic impact? Can CEHRT achieve better patient care while improving the bottom line? First, there are the initial costs of adopting a new technology and learning to use it. In addition, protecting the electronic sharing and standardization of such sensitive information requires regulation and oversight to ensure appropriate use, just as it has for financial institutions and corporate industries. Although it adds to the economic costs, oversight and third-party accreditation/certification programs add value and help the healthcare industry achieve standardization and meet the regulations to protect the public.
Accreditation/certification programs can even reduce costs through risk mitigation and prevention of inappropriate use of information.
In the end, it’s unlikely that the political storm surge will breach hospital walls, derail HITECH or wash out CERHT incentives. Business needs and decisions — not ideologies — drive adoption of EHR and keep the healthcare industry on dry ground.
Lee Barrett is executive director of the Electronic Healthcare Network Accreditation Commission.