The American Medical Association Weighs in on Electronic Medical Records and Meaningful Use Criteria
PWeR®; Will Soon Provide Solutions
For those who have been reading “The PWeR®; Perspective” this year, you have noticed that our perspective on the Future of EMR has been very consistent. We have maintained that any real solution for providers has to be easy to use; it has to be easy to install, safe and secure; it has to be delivered and supported at the lowest cost possible; and most importantly, it has to provide a form of integration of medical records between unaffiliated providers who happen to share a single medical patient (unlike integrated delivery systems like the Mayo or Cleveland Clinics who provide continuous care of a patient). Quite simply for any EHR to be an effective solution, it must provide our “One Patient…Total Connectivity“™ strategy.
On April 16, 2013, six United States Senators released a 29 page report titled REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health-IT. The report was very critical of the current administration’s plan to incentivize and require certain “Meaningful Use” criteria from all healthcare providers who receive Federal grants.
PWeR® has always advocated for the need for higher quality care, lower cost and the critical role that “information technology” can play in what we are confident is a worthy goal. Unlike PWeR®, few organizations we know have filed for patents on health information technology, even less have actually received them, or have a management and founding team that has supervised companies that have managed the care of thousands of patients a week. Given these achievements, we believe our views and positions are grounded in the reality of what is needed and being demanded for by the healthcare community at large.
Our thoughts and comments about what is broken in the system or regarding various policies being, or to be, implemented are our views and reasons why we believe that the U.S. healthcare system is the most inefficient industry in the U.S. and in the world. We can recite piles of data on why the U.S. spends more than any other developed country with a population greater than 25,000,000 people, and why we are “middle-of-the-pack” in terms of life expectancy and infant mortality. However, when the American Medical Association (AMA), and the American Osteopathic Association, as well as many other associations of medical professionals start throwing up red flags, it may be time to stop and determine if the medicine is more harmful than the disease. Real solutions are needed based on innovation and paradigm changes. We cannot afford as a society to get this wrong, and turning our back on the transformative nature of technology and go back to paper records is insane and equivalent to the horse and buggy.
In this PWeR® Perspective, we will only refer to the AMA’s 9 page letter on the subject that should carry a great deal more weight. The AMA is reported to represent over 200,000 medical doctors in the U.S. It has been the leading voice in the healthcare profession since 1847, and is responsible for credentialing over 140 medical schools in the U.S. So when they say we have a problem, someone should listen.
Few people disagree, that EMR/PHR/EHR saves lives. Few disagree, that it is in our society’s best interest that EHRs should be deployed in every doctor’s office and hospital in the country; and most agree that a government that manages nearly 50% of a nation’s total medical expenses (Federal and State programs) has a vested interest, and should incentivize, nationwide adoption of EHR. Nearly everyone also agrees that the U.S. Government can, and should use its power to align financial incentive and disincentives with those options. What the AMA has cautioned is that we need to do a better job as we move toward a system wide adoption of EHRs. The biggest hurdle for an EHR program, and the push by the U.S. Government, has always been creating the functional interoperability amongst the 1,000+ EMRs/EHRs that are certified, deployed, and in use throughout the industry today. Few, if any companies have even tried to become the truly comprehensives provider that is driven by interoperability. So far, not only has the industry created many silos, it has made them taller and wider, and certainly not interconnected. Additionally is the need to have systems that can operate on desktops and laptops, as well as on tablets and mobile smart devices – this is currently a rare commodity.
While the AMA is concerned about interoperability, the organization’s most immediate issues deal with the “Stage 2 Meaningful Use” requirements that go into effect by the end of Oct., 2014.
AMA Executive Vice President and CEO James L. Madara, MD states in their letter:
“The AMA firmly believes that the most prudent course of action is to comprehensively evaluate what worked well in Stage 1 and assess where implementation challenges remain.”
The AMA is concerned this will negatively impact the healthcare industry if the pace is not slowed. They point to requirements that are nearly impossible to meet, not relevant to medical practices, and put an additional burden on patients. The greatest complaint, however, is that ease of use and simplicity were not requirements of the EHR certification process.
Dr. Madara continued to state:
“The AMA firmly believes that the [meaningful use] certification process must be retooled in order to address a variety of problems many physicians are experiencing with their use of certified EHRs. ….Physicians are complaining that the certified EHRs available in the market are not matching their clinical needs.”
The AMA actually recommends that no new provisions be added; that “Meaningful Use 2” should have some flexibility and that the deadline should be extended to 2017.
In the near term, the AMA Report points out the biggest current issue is the real lack of standards for integration of medical records, in practice requiring medical professionals to re-enter information or do manual filtering of patient information received from another provider.
For demonstration purposes, a patient with six health problems may see five doctors. With current protocols, each physician documents a problem list in his or her own terms. In the end, a physician trying to figure out the entire wellness of his or her patient, has a potential option to access and transmit medical records using an HL-7 protocol. In reality what happens, IF THEY DO IT, is that they will find un-reconciled information, with the same set of problems listed in many different ways. The problem list may be sorted, yet that takes time, and there may be no way to save the work in a health information exchange. This is why there are very, very little HL-7 transfers between unaffiliated providers.
The average cost per physician to install, implement and upgrade a certified EHR is $54,000, plus $10,000 in annual maintenance costs, the AMA stated, citing research conducted by the Center for Medicare & Medicaid Services (CMS). These costs do not account for all the functionalities required by CMS, such as purchasing lab interfaces to view test results electronically; some of these interfaces cost thousands of dollars. As a result, Meaningful Use incentives do not cover average implementation costs. Incentives from Medicare are up to $44,000 per doctor, allocated over five years, or $63,750 per doctor, allocated over six years, if they can attest under the Medicaid program.
This Medicare incentive is actually 2% less than what had been authorized in the 2009 legislation, creating the bonus program because of mandatory budget cuts through sequestration, which also cut physician Medicare payments by 2% beginning April 1, 2013. The Medicaid bonus program was not affected by sequestration.
As we have reported, providers soon will be penalized for not using EHRs. A 1% cut will be assessed in 2015 for providers who do not begin demonstrating Meaningful Use by July 2014. The penalty will grow to 2% in 2016 and 3% in 2017.
PWeR® is a Solution.
PWeR® has been working on a platform for the last 5 years, (now Version 2.0) that is just months away from industry unveiling. This platform is called PWeR® for Personal Wellness electronic Record® and addresses most of the issues brought forward by the AMA.
• As a cloud-based platform, PWeR® has very low cost to “install” and available anywhere there is internet access, by provider, patient or emergency medical personnel (with appropriate protocol and emergency only access).
• Paid as a monthly subscription service fee; one comprehensive payment that includes all platform cost, billing, Rx, reporting and transfer cost; the cost is generally less than $1,000 a month per provider.
• No software upgrade fees, nor long-term commitments.
• As a cloud-based platform, PWeR® has minimal computer or hardware cost.
• Accessible and functional through desktops, tablets and most smart phones.
• Complete support, online tutorials, 24 hour phone support in U.S. and intuitive 1- or 2-step access to most screens.
• A revolutionary way for providers to share a patient’s records online based on our patented and patent pending technology, all with appropriate HIPAA compliance and best-practices processes.
• PWeR® will help providers comply with one of the most difficult component of MU2 that requires 5% of a provider’s patients view their medical records annually online. Through PWeR®, patients effectively qualify ALL of their providers with just a single access point within the patient portal provided as part of the base platform.
• Designed by individuals with decades of experience in medical practice processes, functions and habits, not just people with software experience with book knowledge.
• Founders and management are committed to solutions through an innovation edge.
The future of healthcare belongs to a “patient centric platform” versus the provider centric installation of today. Our trademarked and patent concept of One Patient…One Record™ platform design will be a stronghold in a whirlwind of political healthcare controversies.
About PWeR®, Inc.
PWeR® is an innovation-driven healthcare services organization purposefully designed and structured to bring effective change to the U.S. healthcare industry. The foundation of the Company is in the design, development and deployment of innovative solutions, technology, products, and services to the healthcare industry. Our technology solutions are intended to assist physicians, hospitals, and health systems, as well as government and private sector payers, to manage treatment outcomes through a patient-centered wellness concept, our trademarked concept of One Patient…Total Connectivity™. Our premier platform, PWeR®, (Personal Wellness electronic Record™) is a 21st Century electronic health records (EHR) solution that will host medical records and permits interactive use.
There are certain statements contained in this PWeR® Perspective or Opinion Paper that are not based on historical facts and are forward-looking statements, as the term is defined in the Private Securities Litigation Reform Act of 1995, and are subject to substantial risks and uncertainties. This Paper is for educational and informational purposes only and is based on our opinion of a highly volatile political subject. The Company does not undertake any obligation to release any revisions to these forward-looking statements publicly or to provide any update to this Paper to reflect events occurring after the date of this Paper or to reflect the occurrence of unanticipated events.
PWeR® is a Registered Trademark of The Quantum Group, Inc. and it assigns or licensed users, in the U.S., China, EU and other nationalities.
FOR MORE INFORMATION, PLEASE CONTACT:
Noel J. Guillama: 1-561-904-9477 NGuillama@myPWeR.com