With the promise of financial incentives and the threat of Medicare payment cuts, the federal lawmakers have persuaded physicians and hospitals to adopt electronic health records. The new care and payment models look upon EHRs as a very positive feature. However, medical service providers are in a dilemma with CMS waking up to the fact that EHRs may have another side to them.
The present concern CMS has is whether doctors are taking advantage of the EHR system to bill higher level services. Physicians however, are strongly opposed to this view. They have already expressed their dissent on this matter to the CMS. On their part, the CMS has already embarked on a study to find whether differences exist in the coding patterns of those who have implemented electronic health records and those who have not.
Physicians find themselves trapped between two impasses – the pressure to adopt EHRs on the one hand, and the criticism that they are exploiting the new system to their advantage. Most of the physicians are in fact unhappy with the EHRs they have introduced in their practices. They were comfortable with the traditional medical record system, which allowed them to report their findings and decision making processes for their own reference as well as for communication purposes with other physicians. Though many physicians would agree on the merits of the new system, the workflow processes required are regarded frustrating. Searching, clicking and scrolling required to complete even simple documentation is a huge waste of time and effort. So to physicians, the EHR system is not a money-making option, but something that is impeding their normal, smooth workflow.
Providers have purchased electronic health record systems following the pressure to demonstrate meaningful use, but the truth is that most of these systems are not optimized for the end users’ needs. As a result, they could even hamper the provision of appropriate clinical care.
And what about the so-called upcoding said to be rampant with the new system? Observers believe that this may after all not be upcoding, but rightful coding made possible by the EHR system. Earlier, healthcare entities worried about fraud and abuse used to undercode many services, when they were not sure of the complexity of the services. Another possibility is that Medicare beneficiaries coming into emergency departments with complex conditions may be requiring more intricate services, as revealed in a study published by the American Hospital Association. Statistics show an increase by 9% in the average severity of illness during the period 2006 – 2010. Moreover, Medicare beneficiaries are also opting for emergency care at a higher rate.