The EHR incentive program being run by the US federal government is an initiative to encourage EHR adoption among clinics and hospitals to provide better healthcare for patients. It offers financial incentives for compliance to those participants attesting to meaningful use objectives. The program is slated to conclude in 2016 and providers who do not implement an EHR are likely to get reduced reimbursements from Medicare.
Apart from the financial cost involved, the complexities involved in transitioning from a paper-based system to a digital one has perplexed many physicians and practices. In addition to the federal mandate however, medical professionals have to deal with various state legislations as well. A few state legislatures have passed laws of their own to encourage EHR adoption, some of which are more stringent than the national program. Unsurprisingly, these are states that have higher than average EHR adoption rates and are keen to improve innovation in the health IT industry.
In 2007 itself, the Minnesota state legislature mandated that all physicians must have an EHR system which is interoperable and capable of connecting to a Health Information Exchange (HIE) by 2015 . The State also requires all physicians to offer electronic prescriptions by 2011. The regulation clearly states that it is not enough to have an EHR system in place, it must be one which is capable of exchanging information with other health service providers as well. Minnesota is also the first state to include dentists and orthodontists in the list of health providers who must implement a certified EHR system . Unlike the CMS program however, there are no financial incentives to help physicians achieve the mandate.
The Massachusetts state mandate is much more stringent in its requirements. Under the state directive, all physicians must demonstrate knowledge and skills required to operate various features of EHR systems such as e-prescribing, computerized order entry etc. by 2015 . The penalty for noncompliance is quite harsh: health professionals may face a loss of their license. In contrast, Minnesota does not specify any penalties for noncompliance although it is possible that they might be added in the future.
Maryland is taking an indirect approach to encouraging EHR adoption. Instead of targeting health professionals, a state law passed in 2010 says that private insurers should incorporate incentives and penalties into their reimbursement structure. If more states follow these examples and start legislating EHR adoption, health providers will have to comply with both state and federal regulations, which can significantly increase the time and costs involved for achieving compliance.
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