Publication Date: October 22, 2004
New York—Connecting for Health … A Public-Private Collaborative today released Financial, Legal and Organizational Approaches to Achieving Electronic Connectivity in Healthcare, a report which proposes a level of financial incentives necessary to significantly increase the adoption of electronic health records (EHR) by doctors. The report, undertaken by Connecting for Health’s Working Group on Financial, Organization and Legal Sustainability of Health Information Exchange, proposes incentives at a rough level of $3-$6 per patient visit or $0.50 -$1.00 per patient per month. The report notes that small and medium sized practices, while likely to benefit more than larger ones from interoperability, will require greater attention and assistance due to their lack of resources, and suggests that financial and other types of support should be provided to local and regional electronic health record efforts and information sharing collaboratives.
“The goal of this Working Group was to examine the barriers faced by ambulatory care providers in adopting health information technology and then to use any available empirical data to identify potential starting points and near-term opportunities for physician practices to adopt health care information technology,” said John Glaser, PhD, Chief Information Officer at Partners HealthCare Systems Inc., and chair of the Working Group. “This report articulates a qualitative approach to examining the kinds of incentives needed to encourage the of adoption electronic health records.”
“Electronic health records have the potential to help reduce medical errors, lower costs and empower patients,” said Carol Diamond, MD, managing director at the Markle Foundation and chair of Connecting for Health. “However, without the widespread adoption of electronic health records by small and medium physician practices – that represent more than half of the practices in this country – and the requirements for achieving the level of interconnectivity necessary to allow for the effective exchange of health related information, the benefits of information technology cannot be fully realized. We hope this report sparks a full and frank debate over the issue and that it can be a first step toward realizing the potential of electronic health records.”
The report concludes that the current business case for the adoption of health IT systems is not sufficient and that financial incentives are necessary to encourage health care providers to adopt IT systems that allow for interconnectivity to improve the quality of care. The report also finds that initial financial incentives for small and medium sized practices will need to cover most of the costs of adopting electronic health records, but that over time, these incentives will transition to performance-based incentives. The range of incentives is estimated to be $12,000 – $24,000 per full time physician per year. The analysis also shows that the business case for the incremental adoption of applications of health IT is sound, as long as the applications are interoperable, and suggests that e-prescribing and on-line tools for chronic disease management are good starting points.
With an increased focus on health information exchange, and a significant influx in related funding available through government sources such as the US Department of Health and Human Services and its Agency for Healthcare Research and Quality, as well as organizations such as the eHealth Initiative, there is an urgency to provide early experimenters with as much knowledge as possible. To overcome the organizational barriers to the adoption of health IT systems, communities need to assess their readiness for data sharing, including an evaluation of their technical, clinical and organizational capabilities. Leadership will also play a crucial role because the report finds that communities will need a neutral convener to catalyze action and encourage participation in the system.
“To fully realize the potential of electronic connectivity in health care, it is imperative that we have commonality in place – that is, some common approach to organizing information sharing activities at the local or regional level. ,” said Nancy Lorenzi, Professor of Biomedical Informatics and Assistant Vice Chancellor for Health Affairs Vanderbilt University Medical Center Informatics Center, Eskind Biomedical Library and member of Connecting for Health’s Working Group on Financial, Organization and Legal Sustainability of Health Information. “Without careful planning for the way regional efforts organize themselves and the standardization of some minimal information sharing practices, we will fail to achieve the ability to safely and effectively exchange information, leaving us no better off than we are now.”
The report concludes that most management and legal issues related to the establishment of a secure, confidential health information infrastructure can be addressed in the context of existing law and through the use of contracts.
Organizationally, the report urges health care leaders to create regional technology support organizations to manage health information exchange infrastructures and diagnostic tools to assist communities in assessing readiness and to identify common features of successful information exchange infrastructures, and to disseminate their findings.
The report is being released and discussed at today’s Health Information Summit in Washington, D.C. A full copy of the report can be found here.
Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.