Over the past four months, Oklahoma hospitals and physicians have
received a little more than $25 million in Medicaid incentives to
put their electronic health record systems in place.
That money, made possible through the federal stimulus program,
is helping providers adopt a new way of operating that can be
expensive and time-consuming. According to the Oklahoma Health Care
Authority, which administers the state's Medicaid program, 430
providers and 22 hospitals have received incentives as of this week.
Medicare incentives are available as well - up to $44,000 over
five years for physicians who adopt an EHR in 2011 or 2012.
Physicians can receive incentives through only one program, but
hospitals may receive both Medicare and Medicaid incentives.
Medicaid incentives are arriving earlier to support more of the
initial costs of adopting an EHR.
The incentives are a help, providers say, because adopting an EHR
requires much more than the cost of hardware and software.
"As a physician, we understand the value of what it means to have
this information portable, and the impact of that on the quality and
safety of care that we provide," said Dr. Brian Yeaman, a Norman
family physician and chief medical informatics officer at Norman
Regional Health System. "But the reality is that it's very
cumbersome and difficult at times to accommodate a computer while
you're trying to care for a patient. There's a technical hurdle to
overcome, but there's also a period of time where you have to alter
your productivity and see fewer patients to allow the system to be
installed and get everyone up to speed. So those incentives are an
attempt to cover all of those associated costs, including lost work
time, particularly in the clinic setting."
Norman Regional "went live" with its EHR three years ago, said
John Meharg, director of health information technology. The system
cost about $20 million, and he said the hospital should be able to
recoup nearly half of that cost through incentives. In the next few
weeks, it should receive its Medicaid payment of $1.1 million, he
said. By July 1, the hospital plans to be compliant with Medicare's
Stage 1 "meaningful use" - 24 measures a hospital must meet in order
to receive its incentive, he said.
Incentives are based on whether a provider or hospital has
installed an EHR that is certified and whether it meets "meaningful
use." The Stage 1 criteria for meaningful use focus on
electronically capturing information in a coded format, using that
information to track key clinical conditions, communicating that
information for care coordination purposes and initiating the
reporting of clinical quality measures and public health
information. Stage 2 and Stage 3 meaningful use requirements will
expand the use of EHRs and focus on achieving improvements in
quality, safety and efficiency. …