The Medicare Payment Advisory Commission is designed to help Congress make good decisions about Medicare policy. The work coming out of the Commission is usually great; unfortunately the same cannot be said for what Congress or CMS does with the MedPAC reports. Recently the Commission examined the status of the electronic medical records incentive program. (MedPAC Presentation) This is one of the most heavily promoted aspects of the reform law, with the government and providers spending tens of billions of dollars to “modernize” health recordkeeping. The Commission finds that while the program is being implemented largely as was suggested and as it was designed, with meaningful use requirements so that the new hardware and software is used in a way that benefits patients by improving health outcomes, the uptake is slow.
Specifically, only 16% of hospitals have achieved even the rudimentary first stage meaningful use requirements and only 6% of physicians have. What is apparent is that for many professionals and some hospitals, the financial incentives, and the looming penalties for non-use, are not enough for them to be motivated to engage in “meaningful use”. The reality is that there is a significant cost, not fully compensated by the incentive payments, to not just acquire software and hardware, but to redesign workflows around the new systems. It is disruptive and reduces productivity, which many providers can’t afford at a time when their reimbursements are under pressure. But most distressingly, research continues to show that the benefits so highly touted for these systems don’t show up in real medical practice. Electronic medical records may be a better way to track and communicate data, but right now there is little evidence to show that they result in better care or lower net costs.