Feds Continue To Push For EHR Implementation

The federal government's keen interest in electronic health records -- fueled by President Bush's call in 2004 to make EHRs available to most Americans within 10 years -- continues to grow, as evidenced by recent HHS and related activity.

During the past few weeks, HHS reported to Congress about an electronic prescribing pilot project, asked permission to conduct a survey to measure adoption of EHRs among physicians and group practices, and endorsed a recommendation that federal contracts with health plans and insurers include provisions to reward physicians for using certified EHRs.

In mid-April, HHS Secretary Michael Leavitt announced in a report to Congress the results of an electronic prescribing pilot project undertaken in 2005. The pilot project was designed to test whether new electronic prescribing standards were ready for widespread adoption.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 directed HHS to establish federal prescribing standards that all electronic prescribers must follow for their patients enrolled in Medicare Part D. The standards are designed to help cut both medication errors and health care costs for Medicare patients.

The pilot project successfully demonstrated that three initial standards, of the six that were tested, already are capable of supporting e-prescribing transactions in Part D. These standard transactions give physicians information about their patients' formulary and benefits information, medication history, and so-called fill status of their medications.

The pilot project covered eight states and was conducted by CMS and the Agency for Healthcare Research and Quality, or AHRQ. Five pilot sites, including Brigham and Women's Hospital in Boston and University Hospitals Health System in Cleveland, participated in the project.

Copies of the report to Congress and the full evaluation are available from AHRQ's National Resource Center for Health Information Technology.

Recently, HHS also announced that it was seeking permission from the Office of Management and Budget to conduct a survey that would measure rates of adoption of EHRs among physicians and group practices.

HHS plans to survey 10,000 randomly selected physicians and practices and would include responses from practice managers. The agency wants to know what factors help or hinder physicians as they consider EHR implementation.

The request was published in the April 27 Federal Register (PDF file: 1 page/44 KB. More about PDFs.). Survey results will be available in the fall.

On April 24, an HHS advisory group, the American Health Information Community, or AHIC, endorsed in principle a recommendation from its Electronic Health Records Workgroup. The recommendation said that federal contracts with health plans and insurers should include provisions to reward physicians for good performance, including the use of EHRs certified by the Certification Commission for Healthcare Information Technology.

At the same meeting, AHIC rejected another proposal from the same workgroup that called for Medicare to institute a differential reimbursement system that would pay physicians who use EHRs more than those who do not. AHIC questioned the legality of such a payment system as well as the lack of a definition for the term "using EHRs."