Health Information Technology

Ten things optometrists should know about EHRs:

1. EHRs are not mandatory. The AOA encourages doctors to use EHRs and provides information at www.aoa.org but does not recommend specific products.

2. Provisions within ARRA give significant incentives in Medicare and Medicaid for doctors to use EHRs. Last winter, the AOA successfully convinced Congress to include ODs in these programs.

3. Doctors who begin using EHRs by 2011 or 2012 can receive the maximum reward, up to $44,000 over five years through the Medicare program (75 percent of Medicare-allowed charges up to a capped amount for each year). But if you wait until 2015 to start, there are no incentives.

4. Doctors must use the EHRs in a "meaningful" way. Merely purchasing/installing software will not be enough. Doctors will have to demonstrate that they are using the EHR as a tool to improve patient care.

5. Beginning in 2011, Medicare physicians who implement and report "meaningful use" of EHRs will be eligible for an initial incentive payment up to $18,000. ODs who practice in health professional shortage areas may qualify for an additional 10 percent incentive through Medicare.

6. Doctors who do not start using EHRs by 2015 may face penalties in Medicare. However, the HHS has the authority to make exceptions to the Medicare penalties on a case-by-case basis for physicians who demonstrate significant hardship (e.g., a physician who practices in rural areas without adequate Internet access).

7. The EHRs must be "certified." The AOA has worked alongside ophthalmology organizations to secure a certification track for eye care EHRs, which was previously unavailable for vendors of eye care EHRs. The AOA believes the federal government will provide a separate path to certification specifically for ARRA so that all EHRs regardless of specialty or designer/ creator can be certified for purposes of the stimulus.

8. In Medicaid, the payments begin as high as $25,000 for the first year and up to $10,000 each of the following five years. But the Medicaid program has additional hurdles and is only practical for practices with a high volume of Medicaid patients.

9. One doctor can't get available bonuses from both Medicare and Medicaid.

10. Doctors should begin to make plans to implement EHRs in practice before the end of 2010. The AOA will have more guidance about certification and meaningful use in the months ahead.

AOA members with questions or concerns should contact Rodney Peele of the AOA Washington office at 800-365-2219, ext. 1348 or rpeele@aoa.org.

 

Other Helpful Commentaries

The following are part of a series of ongoing updates from Dr. David Blumenthal, National Coordinator for Health Information Technology.

Update: December 30, 2009

  • Standards and Certification Criteria to Support Meaningful Use of Electronic Health Records
    As we look toward 2010, we can envision a transformation of our health system to improve health care quality, efficiency, equity, and safety through the use of health information technology (HIT), while providing the foundation for continued, measurable improvement in our nation’s health. The adoption and meaningful use of information technology in health care is central to a necessary and overdue modernization of our health system.

Update: December 18, 2009

  • Keeping a SHARP Focus on Innovation
    Today the Obama administration announced the availability of $60 million in Recovery Act funds to support the development of the Strategic Health IT Advanced Research Projects (SHARP) program. SHARP awards will fund research focused on identifying technology solutions to address well-documented problems impeding broad adoption of health IT. 

Update: December 2, 2009

  • Beacon Communities: Shining a Light on the Real Impacts of Health IT
    Today the administration announced the availability of $235 million in funds to support the Beacon Community Program. The Beacon Community Program (BCP) will help to accelerate and demonstrate the ability of health IT to transform local health care systems, and to improve the lives of Americans and the performance of the health care providers who serve them. 

Update: November 12, 2009

  • The HITECH Foundation for Information Exchange
    I recently reported on our announcement of State Health Information Technology Grants and grants to establish Health Information Technology Regional Extension Centers, as authorized under the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009 (the Recovery Act). 

Update: October 1, 2009

  • “Meaningful” Progress Toward Electronic Health Information Exchange
    Today I want to discuss the important term “meaningful use” of electronic health records (EHRs) – both as a concept that underlies the movement toward an electronic health care environment and as a practical set of standards that will be issued as a proposed regulation by the end of 2009. 

Update: August 20, 2009

  • News on Next Steps Toward Nationwide Health Information Exchange 
    Today’s announcement from the White House regarding the rollout of the first two in a series of HITECH priority grant programs represents a critical step forward in laying the groundwork for meaningful use of electronic health records (EHRs). These programs will offer valuable help to health care providers in the selection and incorporation of EHRs into clinical practice, and for States and their designates to assure that statewide information exchange is developed with an eye toward nationwide connectivity across the health care system. 

Update: August 19, 2009

  • Electronic Health Records and the 21st Century Health Care System 
    In my role as National Coordinator for Health IT, I have the privilege to be part of a transformative change in health care that will help to extend the benefits of health information technology (HIT) to all Americans. With the passage earlier this year of the Health Information Technology for Economic and Clinical Health (HITECH) Act, we have the tools to begin a major transformation in American health care made possible through the creation of a secure, interoperable nationwide health information network.

 

E-Prescribing

Overriding the President’s veto, Congress enacted the Medicare Improvement for Patients and Providers Act (MIPPA) on July 15, 2008. In addition to averting significant Medicare payment reductions to physicians, MIPPA creates new financial incentives to encourage Medicare providers to adopt and use technology to order prescriptions electronically. Experts expect e-prescribing to reduce medical errors and help clinicians provide care in a more cost-effective, efficient and safe manner. Congress provides a 2 percent bonus in 2009 and 2010, reduced to 1.0 percent in 2011 and 2012, and 0.5 percent in 2013, for eligible physicians on all Medicare claims if they successfully e-prescribe. Congress authorizes Medicare to penalize eligible doctors who don’t e-prescribe 1.0 percent in 2012, 1.5 percent in 2013, and 2.0 percent in 2014 and beyond.

If you are currently e-prescribing, upcoming changes to Medicare regulations may impact the way you prescribe. If you are not an e-prescriber, be advised that Congress may soon incentivize/penalize based on use of e-prescribing. Visit www.GetRxConnected.com/Optometric for a free assessment.

E-Prescribing is an electronic way to generate prescriptions through an automated data entry process utilizing e-prescribing software and a transmission network that links to participating pharmacies. E-prescriptions are sent electronically through a private, secure, and closed network so prescription information is not sent over the open Internet or as e-mail.

E-Prescribing is not simply emailing prescriptions or faxing prescriptions to the pharmacists. E-Prescribing replaces old, error-prone approaches to prescribing - e.g., handwritten prescriptions, computer-printed prescriptions and computer-faxed prescriptions.

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