Michael Planchart, my colleague, posted a blog a few days ago about the Fed’s decision to delay the ICD-10 implementation deadline. He makes some great points and I don’t completely disagree with his view that the delay will have negative impacts. Michael asks, “Could someone please explain to me why we should halt any national Healthcare IT project?” I have an idea.
I have met with many healthcare professionals, healthcare IT directors and CIOs. Those who are not underwater deploying a massive EMR system are underwater dealing with Meaningful Use, Core Measures, Accountable Care, and ICD-10. They don’t have time to follow Stephen Covey’s advice to “sharpen the saw” because there are too many federally mandated deadlines consuming their time.
I call this “Fed Fatigue.” How much of this can the healthcare industry sustain? The payors are cutting reimbursements. Local physicians groups are deploying EHRs. It is predicted that 50% of providers will adopt EHR technologies in the next two years. This is up from 20% in 2009.The hospitals are upgrading or deploying systems on a larger scale. Medicare is stopping payments for unnecessary ED visits, yet requiring everyone who enters the ED get treatment. All this activity in healthcare is consuming bandwidth from people that are habitually overworked. It is causing everyone to triage or skip projects that could significantly improve outcomes in favor of those that are only showing marginal improvements. In fact, it has been shown that giving access to images and results doesn’t decrease test orders but, in fact, has increased them between 40 and 70 percent.
My neighbor, a physician, deployed a new EHR system last year to attest for Meaningful Use. He told me he is spends up to 2 extra hours per day inputting or correcting notes and codes in the new system. This is on top of a 10+ hour workday. This new EHR has piled 20% more work to his plate without adding any immediate value to him or his patients. We discussed the benefits of an electronic record that can be shared with other locations and the patient themselves. I explained the benefits of discrete data versus text or faxed data. We explored the future versus today. All in all, I think it was a productive discussion, but it didn’t give him more time or remove the sting of extra work.
Do the math: If every program adds just 5% more work to a provider’s plate, four major initiatives account for at least 20% more workload. This is 20% more that is taking time (and money) away from the provider.. Perhaps a reprieve, albeit very slight, is in order. Maybe the Fed’s decision to delay ICD-10 will give the healthcare industry some time to rest.
