Electronic Medical Records:  Incentives, Penalties, Guidelines and Interoperability, Where Do I Start?

Incentives and Penalties 

In an effort to incentivize the switch to EMR the HITECH Act (section of the American Recovery and Reinvestment Act) allocates funds for Medicare  to offer incentive reimbursement to those participating physicians who make the switch sooner rather than later.  Specifically, Medicare participants who adopt “approved” EMR in the following years may receive the following incentive compensation through 2016: Year 2011: $48,400, Year 2012: $48,400, Year 2013: $42,900, Year 2014: 38,500.  Whereas, Medicare participants who do not adopt EMR by 2015 will be penalized by reduction in their Medicare reimbursement by 1% for every year they do not switch to EMR.

Guidelines

The HITECH Act sets forth criteria EMR must meet to qualify for reimbursement by Medicare, specifically, the EMR must be certified and the EMR must provide a “meaningful use”.  At the present time, definitions for “certified” and “meaningful use” are being refined and will be promulgated by the Department of Health and Human Services (HHS).  In the meantime, it is likely that for EMR certification will be based partly on the Certification Commission for Health Information Technology (CCHIT) guidelines.  CCHIT is a private organization that certifies EMR systems based on 475 criteria, including functionality, interoperability and security.  “Meaningful use” will also be defined by HHS and indicators show that e-prescribing, electronic exchange of medical records and interoperability of systems will be determining criteria.

Interoperability?

For many grappling with the concept of incorporating EMR into their practices, the question of interoperability is key.  No one wants to spend money on software that is not going to be compatible with the health systems they work with regularly and require payment from.  Unfortunately, the technology at this stage is not refined enough to answer the burning question of: will this system cooperate with the others I work with?

Getting Started 

The best answer available at this time for physicians searching for EMR right now is to look at a company offering the right product for your practice with the right amount of personal services and support.  With the right team on board to help with the EMR transition and management thereafter, including appropriate tech support, interoperability will not be an issue.  Currently, the market is somewhat flooded with software companies offering EMR.  My advice, work with a full service company that offers assistance or provides hardware, has an easy to use EMR system and offers IT support.

If you would like referrals to billing companies offering EMR or companies that offer EMR systems, please do not hesitate to ask.  I also recommend attending information seminars at local Medical Society meetings.

For additional information on this topic, please contact Jennifer Kirschenbaum at (516) 747-6700 ext. 208 or at Jennifer@Kirschenbaumesq.com. This email is for education and discussion purposes only and does not constitute legal advice.  To access prior healthcare email newsletters or articles visit: www.kirschenbaumesq.com/healthcarearticles.htm.