Finding Meaning in a Complicated EHR Picture

In late August, the Centers for Medicare and Medicaid Services (CMS) announced yet another extension of Stage 1 Meaningful Use benefits. Specifically, it will allow users to qualify for benefits for any three months in the remaining calendar year and earn the full stage 1 incentive payout, regardless of whether the user was already scheduled to attest for Stage 2 in 2014. While this is good news for users who have already benefited from the incentive program, the extension points to a messy regulatory future for Electronic Health Records.

THE EMERGING HIT NARRATIVE

Stage 2 of the Meaningful Use incentive program is set to begin in 2015, with Medicare penalties being enforced against those who aren't meaningful users. These penalties, however, will likely not be strong enough to swing the numbers in the right direction. That's not to say that the EHR experiment is a failure, but rather that the government's attempts to guide the curve of Health Information Technology (HIT) was not only misguided but misjudged, as well. Over the past several years, I have chronicled the sometimes rocky road of EHRs as they pertain to Meaningful Use and government incentives, but in that time the real narrative of EHRs has emerged from both users of technology and the continued innovations from various EHR vendors.

To take a step back and survey the larger healthcare picture, it's important to keep in mind that most innovations take time. Moreover, significant shifts in thought and practice often take years, sometimes decades to achieve full realization. The pace of the digitalization of healthcare is no different. Therefore, while it is critical for physicians to keep their pulse on regulatory affairs as they relate to EHRs, the best thing we can all do in order to make the most informed decisions for our patients and practices is to observe and learn from those who have implemented this technology.

Many options are now available for clinicians who want to go digital. Each company and system offers something slightly different. It is our job to do the homework and find out what works best for us. That means interacting with vendors at meetings and online, and speaking with colleagues about their experiences with a given system.

INTRODUCING THE EHR USER SERIES

Over the next several months, Practical Dermatology^® magazine's Digital Practice department will host a series of articles written by users of different EHR systems. Each author—a physician—will reflect on the pros and cons of her or his system, as well as offer any tangible feedback about selecting and investing.

There will no doubt be bumps along the road as digital technology is integrated more fully into the American healthcare system. But if we do our part and make the most informed decisions based on the available evidence (just as we do in practice each day), both our practice and our patients will be better off. Hopefully the perspectives you are about to read in the coming months help you, no matter what stage you are at on your own journey with technology in practice.

Dr. Kaufmann is co-chair of the Dermatology workgroup for CCHIT. He is also on the Medical Advisory Board of Modernizing Medicine.