CSC released two papers detailing its perspective on the major challenges for providers seeking to implement electronic medical records in a fashion that will meet the requirements to receive incentive payments or avoid penalties. One paper discusses physician use and one hospital. (CSC Paper 1) (CSC Paper 2) The papers are designed to help providers identify the many problems they will have in selecting and operating an EMR. As ample research has demonstrated, doing electronic medical records in a cost-effective manner that does not compromise care is not easy. Underlying problems are that the meaningful use incentives will not cover the full cost of the EMR for most, if not all, providers; and that implementing an EMR requires substantial change to existing work processes.
The top issues for hospitals include ensuring proper use of computerized physician order entry, in particular, transitioning all ordering to the EMR, not maintaining a dual paper and computerized system; focusing on adequate and thorough physician training; getting good clinical decision support and clinical information collection and analysis integrated into the EMR; being able to share data across providers and with patients while meeting the enhanced privacy and security requirements; and merging the EMR project with ICD-10 implementation.
Physician challenges are exacerbated by the lesser resources found in most physician groups compared to hospitals. Many physicians don’t have any full or part-time IT staff and taking on a major project is an unavoidable disruption to the business which significantly affects revenue. CSC identified the following as the top hurdles for physician attainment of meaningful use: capturing the necessary data; get physicians involved in adoption early on; start e-prescribing as soon as possible, since this meets several of the meaningful use criteria; and develop a strategy for meeting the health information exchange requirements.
The CSC papers both give a good explanation of the meaningful use requirements and provide a roadmap for identifying issues providers will have to deal with to get their incentive payments.