Just a few days before the comment period closed on the draft regulations defining meaningful use (see all meaningful use comments), the Massachusetts Medical Law Report ran a piece on the HITECH Act incentives for implementation of electronic health records systems, quoting me and a couple other usual suspects.  I highlighted some shortcomings in the proposed rule, and also noted that health care providers need to be implementing EHRs not just for the stimulus kicker … that alone is not worth it:

[T]he regulation calls for all physicians to use e-prescribing 75 percent of the time by 2012.

David Harlow, a Newton-based lawyer and health care consultant, said that this won’t be an easy task, noting that Massachusetts is considered a leader in e-prescribing even though only 10 percent of prescriptions are submitted electronically.

At the same time, other benchmarks seem pointless in light of what many physicians – especially specialists – do on a regular basis, Harlow said.

He referred to a requirement that electronic reminders for preventative care and follow-up be sent to at least 50 percent of all patients age 50 or older.

“Why would, say, an orthopedic surgeon be sending out reminders based on age?” he asked. “That’s really geared toward primary care, yet it’s a measure that’s required in order to get an incentive payment.”

. . . 

Harlow warns that a physician practice should not even attempt to roll out an EHR system if the physicians are only in it for the incentive payments. Though an effective system should ultimately start paying for itself through the internal office efficiencies it creates, a $44,000 maximum incentive payment won’t cover the implementation costs.

On the positive side, there are certainly reasons for moving forward with EHR implementation — as you can read (or hear) in my recent interview with Partners Health Care CIO John Glaser — though not all health care providers are able to absorb the costs as Partners can.  In the long run, however, there are certainly many strong arguments on a variety of fronts about the value of EHRs.  I heard some of those arguments this morning from folks in the patient-centered medical home camp who I saw at a Mass. Technology Leadership Council event — including Paul Grundy, patient-centered medical home evangelist from IBM, who I interviewed last year.  Time will tell whether the widespread adoption of EHRs will truly fulfill their promise, but we are certainly well on our way to finding out. 

David Harlow
The Harlow Group LLC
Health Care Law and Consulting