Just What the Doctor Ordered

The government is hearing the voice of the specialists.

Since the inception of the EHR incentive program in February 2009, specialists have been concerned about their role in a program that is clearly focused on primary care. As I have pointed out before, the legislation’s primary-care focus is borne out by the composition of the decision-making committees, the allocation of funding for associated programs, and the fact that specialists were not even a topic of conversation in the deliberations until late in the game.

I have tried to advocate for the physicians—specialists, in particular—by representing their special issues via the Voice of the Physician Petition, blog postings, letters to Dr. Blumenthal and Secretary Sebelius, and by sending staff to Washington to speak on their behalf. In the last few months, specialists, their medical societies, and industry pundits such as David Kibbe and Vince Kuraitis have speculated that many specialists will not participate in the program.

Apparently, the government is worried and is taking steps to reach out to specialists to assuage their concerns. Last week, David Blumenthal confirmed publicly that specialists will not be expected to add primary-care clinical workflows to their practices to satisfactorily demonstrate meaningful use, and that they can exclude select measures that don’t apply to their practices. (See my HIStalk Practice post for more information.) While nothing in the regulations has changed since the release of the final rule in July, Dr. Blumenthal’s recent statements should dispel physicians’ initial skepticism about the potential exclusions—skepticism that had roots in disappointing PQRI experiences.

Having heard Dr. Blumenthal speak before an audience of ophthalmologists at the recent AAO meeting, I find it refreshing to see a move to a more inclusive program.

One thought on “Just What the Doctor Ordered

  1. Sir,

    Dr. Blumenthal needs to hear from dermatologists loud and clear that point and click EMRs are a surefire pathway to the “going out of business” endpoint.

    I am a “new adopter” of technology. I was one of the first users in the world of an integrated EMR in the Department of Defense. In dermatology, where your volume is very high, and you are using a lot of “mapping” and other visualy intense methods of recording clinical data, it still takes me at a minimum three to four times a long to do a patient encounter than using paper records.

    I have looked carefully at many point and click EMRs and really put two of them through their paces. Both systems were quick in their response and both worked “as advertised”. That being said, I worked through and inputed clinical data for the same standardized clinical encounter about 20 times and really got quite got good at it. It still took me three times as long to complete the “visit” as compared to clincal paper charts!!! This is obviously a non starter.

    I am not a technophobe. I know the value of a good EMR. The problem is that it would slow down the average dermatologist.

    CMS needs to understand that our practice’s solution to the Medicare EMR penalty threat is a simple one. We will likely stop taking new Medicare patients and eventually opt out of Medicare altogether.

    I have yet to talk to any existing high volume medical dermatology practice (outside of a GME setting where your residents are your EMR scribes) that has adopted point and click EMR and has not regretted doing so.

Comments are closed.