Health care organizations which do not qualify for incentive reimbursement have in large part not implemented EHRs, leading researchers involved in a study published in the March issue of Health Affairs to conclude that it is the incentives rather than factors such as improving patient care which are driving EHR adoption.
Under the 2009 federal stimulus legislation, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments. The incentive program, however, excludes home health agencies, inpatient psychiatric hospitals, inpatient rehabilitation hospitals, long term acute care hospitals and nursing homes. While EHR adoption in eligible, short term acute care hospitals is currently at about 12%, ineligible health care organization EHR adoption was described in the study as “abysmally low.”
The study included:
- 4,629 general short term acute care hospitals
- 486 psychiatric hospitals
- 401 long term acute care hospitals
- 237 rehabilitation hospitals
Only 6% of long term acute care, 4% of rehabilitation and 2% of psychiatric hospitals had implemented EHRs. The likely factors impeding implementation were cited as the ongoing vendor focus on the acute care environment (which benefits from incentive reimbursement) and uncertainty regarding which EHR would best suit their unique environment.
With such large numbers of health care organizations continuing to operate in a paper world with little incentive to change, the goal of achieving either the quality or efficiency of care EHR technology promises will remain elusive. Creative and workable solutions will need to be devised to ensure that these disenfranchised health care organizations, which play such a critical role in the health care delivery system, are sufficiently incentivized to adopt EHRs.