The entire Health Care industry is impacted by existing legislation requiring the adoption of electronic medical records (EMR). This adoption is absolutely necessary in order to improve patient care, reduce medical accidents, and in the end reduce total cost to provide care. The Cloud is a key enabler, allowing insurance companies, pharmacies, doctors and hospitals to share information about a patient allowing for quicker and more accurate treatment. Getting there can be a very expensive pain, especially for those organizations with only paper-based patient records. These companies are not just moving their existing IT to the Cloud, they are moving to an automated computer-managed environment, actions that most older companies took decades ago, and a phase newer companies never went through at all. Most small rural medical practices fit into the “paper-based” category. In many rural areas, small medical practices with an aging physician are the norm. For them, the move to EMR to meet the current ObamaCare requirements can be a heavy and long-term burden.
These doctors are faced with four choices:
- Bite the bullet, and spend tens of thousands of dollars and at least a year to comply. While EMR is a federal mandate, the government provides no financial assistance in the conversation.
- Ignore the law and carry on as they have for, in some cases, several decades. In this case the government punishes the doctor by withholding part of their Medicare pay. Most small practices are running fairly close to the edge financially due to ever-increasing malpractice insurance rates, the need for more expensive equipment, and declining insurance payments to the practice.
- Merge into a larger regional organization. The larger organization probably has implemented a compliant EMR and will help the small practice migrate. The doctor loses a lot of control over the hours they work, possibly work location, and even patient selection. They become an employee of a large bureaucracy.
The Medicare reimbursement penalties are significant. Lose 1% for not having a qualified EMR. Lose another 1.5% for failing to enroll in PQRS, a federally mandated program the collects quality data.
For many doctors, especially those over 50, the last option is the one they are selecting, forcing many rural patients to find a new doctor, often many miles away from where they live and work.
To further complicate the migration to EMR, the government is changing, again, the classification codes used to identify diagnoses and diseases within an EMR and in exchanging data with insurers and government organizations. ICD-10 is required by every medical practice in the US by October 1, 2015. This changes how doctors and other medical staff code everything about patient care. Again, when the conversion is complete nationwide it should improve health care significantly, but the path is not easy and not free to the medical organizations. Several state medical associates and the National Physicians’ Council for Healthcare Policy have urged Congress to delay implementation of ICD-10 for two years. At the same time, other groups are pressing for no more delays citing the cost in time, effort and money as they try to meet disjointed deadlines for multiple federal mandates.
The last word:
The impact on you, your family and your business will depend on where you live and your financial situation. One impact we will all face is, at least over the next few years, is the increased cost of medical care and thus for medical insurance while everyone involved in the medical industry tries to keep up with constantly changing government regulations.
All of this confusion also negatively impacts the security of health care data, making us all more vulnerable.
Keep your sense of humor.