Government Prepares to Implement Penalties for Doctors Using Paper Medical Records
By Scott Leuning
Change never comes easy, but the federal government has been pushing the healthcare industry into the digital age over the last several years and those physicians who have not shifted from paper records to electronic health records (EMR) may soon face monetary penalties. Under the federal government’s mandate for the use of EMR, physicians who have either not adopted certified EMR systems or who cannot demonstrate “meaningful use” by the EMR deadline in 2015 will see Medicare reimbursements reduced by 1% in 2015. The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018, and up to 95% depending on future adjustment.
The federal government has given over $30 billion in incentives to assist doctors in installing and using electronic medical records since 2009. Most of these funds have been provided to physicians who are eligible to receive as much as $44,000 in EMR incentive payments over a five-year period from Medicare. Despite these incentives, which typically only cover a portion of the costs to transition from paper records to EMR, there is growing resistance within the health care sector to make the shift to EMR because of concerns of the efficiency and effectiveness of current technology for EMR.
In January 2015 a group of 37 medical societies, led by the American Medical Association sent a letter to Health and Human Services, criticizing the government’s plans regarding electronic medical records, claiming that the current system is cumbersome, decreases efficiency, and presents safety problems for patients.
The primary criticism of EMR is related to technology glitches, such as self-populating fields
that must be closely monitored. The issue of “cutting and pasting” information in a patient’s chart has also raised liability concerns. In a federal government survey in 2014 15% of the responding 10,000 physicians stated that EMR had led them to choose the wrong medication or lab order. While 45% of the respondents to that survey said that technology had alerted them to safety problems, the error rate is considered very high within the medical field. Many physicians agree in principal with the concept of EMR but because of these patient safety problems there is a concern that the push by the government is coming too fast.
Another criticism of the shift to EMR is that doctors now spend more time typing into computers in the exam room instead of interacting with patients. While the technology of EMR may make it easier to send patient health records from one facility to another, it is possible that quality interaction with the patient, which is often a necessary component in diagnosing and treating a patient, will be lost in the process.
The Centers for Medicare and Medicaid Services responded to these complaints by stating that it will ease reporting burdens on doctors in a proposed rule, set to come out in the spring of 2015. However, the proposed rule will not eliminate penalties levied on physicians who do not make the switch to electronic health records. The federal government is continuing its shift from paper records to EMR and it is evident that it is expected that healthcare providers will move with it to this new technology.
While the shift to EMR appears inevitable, it is important for individual physicians and clinics to carefully prepare for the transition from paper records to digital records. Not only should careful consideration be given as to the technology chosen for implementing the shift to EMR, but consultation should be taken with legal counsel to ensure that your practice policies are in compliance with all applicable regulations. Particular issues to be aware of when making the shift to EMR include:
1. Are there safeguards in place to prevent unauthorized access to patient health information;
2. Is staff adequately trained on how to utilize the EMR technology;
3. Are there checklists developed to make sure that fields do not self-populate with information unrelated to current patient exam;
4. Do you have policies regarding cutting and pasting information;
5. Are your records saved and backed-up regularly.
As is the case with any transition in healthcare, it is important to make sure that you remain within regulatory compliance and consult qualified legal counsel on those compliance issues.
Attorney Scott Leuning is a new addition to the Goosmann Law team. He brings twenty years of legal experience to his health law clients. His areas of practice include but are not limited to health law compliance and regulation, physician licensing, medical malpractice defense, employment law, and complex civil litigation. As part of his continuing education, Leuning is completing his postgraduate Masters of Law in Health Law Compliance at the Beazley Institute for Health Law and Policy at Loyola University Chicago School of Law.