NASE News

House Members Urge Administration to Support Health IT for Small Physician Practices

The administration’s health IT program has given doctors and hospital officials financial incentives to adopt Electronic Health Record (EHR) systems that meet federal standards, but lawmakers on the House Small Business Committee’s Subcommittee on Healthcare and Technology are questioning whether the Obama administration has done enough to help physicians in small practices.

In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH), which was included in the American Recovery and Reinvestment Act (PL 111-5), appropriated $2 billion in discretionary funding to the Office of the National Coordinator (ONC) to assist in HITECH program goals. Under the Act, physicians are eligible for financial incentives if they meet “meaningful use” requirements. However, the “meaningful use” requirements, along with the fact physicians cannot receive both Medicare and Medicaid incentives, has made it difficult for many physicians to take advantage of the funding.

Subcommittee Chairwoman Renee Ellmers (R-N.C.), said significant financial, legal, and technological barriers still prevent many practices from moving forward with electronic health records. In particular, she noted the lack of broadband access in rural areas, which prevents the adaptation of electronic records, as well as security and privacy concerns.

These issues remain crucial, as almost 60 percent of office-based physicians work in practices with fewer than ten doctors. These smaller practices have the most trouble taking advantage of HITECH funding due to lack of resources and manpower, Rep. Ellmers said.

Dr. Farzad Mostashari, National Coordinator at the Department of Health and Human Services Office of Health IT, testified that overcoming barriers to the adoption and use of health IT will contribute to job creation. The Bureau of Labor Statistics projects that from 2008 to 2018, the number of jobs for medical records and health information technicians will grow roughly 20 percent, to more than 35,000. Furthermore, EHR implementation requires installation and maintenance services, creating even more private sector growth, in particular for small businesses.

However, other witnesses described the challenges they have faced while attempting to implement EHR systems: Dr. Sasha Kramer, from the American Academy of Dermatology, explained that although she received a grant from state programs that covered nearly half of the cost of the EHR system, the challenges for implementing EHR systems remains too high. She spent over 160 hours selecting a vendor and for training, forcing her to decrease the amount of time spent with patients. Additionally, she is now being forced to implement a new EHR system after experiencing problems with her original vendor. Kramer added finding capital is difficult for solo practitioners like her, and that she would like to see the government provide sufficient financial resources to allow doctors to implement EHR systems.

The Subcommittee’s Ranking Member, Cedric Richmond (D-La.), questioned witnesses Mostashari and Karen Trudel, the Acting Director of the CMS Office of E-Health Standards and Services, on whether penalties for Medicare providers who do not meet the “meaningful use” of IT requirements would use it as an excuse to refuse Medicare patients.

Trudel agreed with Richmond’s characterization, and said current incentives may not be enough to sway physicians from more rapidly deploying EHR systems. Meanwhile, Mostashari said the administration is doing its best to quickly certify and set up more Heath IT Research Centers to provide training and technical assistance to practitioners who need guidance regarding HITECH.