If the Dec. 4 letter
from Health and Human Services
Secretary Mike Leavitt that calls for greater Medicare incentives for electronic
health records (EHRs) seems like it came out of nowhere, that’s because it
The Bush administration has opposed any kind of mandates in
health-IT almost since Day 1 — or at least since HIPAA — but the Leavitt letter
comes closer to a mandate than anything we’ve seen before. The secretary asks
Congress to include EHR incentives in any bill to roll back the planned 10
percent Medicare physician fee cuts for 2008, including giving the Centers for Medicare and Medicaid Services
authority to require ePrescribing at some point in the future.
“Physicians who do not adopt appropriate, available
technology should receive a lower payment than those who do,” Leavitt wrote.
Bombshell? Perhaps. “To me, the push for health-IT has moved
from being a trickle to a tsunami,” says Lillee Gelinas, vice president and
chief nursing officer of VHA Inc. (Irving,
At the Nov. 13 meeting of the American Health
Information Community (AHIC) in Chicago, Leavitt asked the advisory board’s
EHR workgroup to develop a recommendation on EHR adoption within 30 days. He
had one in half that time.
“I’ve never seen the political process work so quickly,”
says Gelinas, who co-chairs the EHR workgroup with Jonathan Perlin, senior VP
for quality and chief medical officer of hospital chain HCA and former boss of the Veterans Health Administration. “Jon Perlin
and I worked like madpeople behind the scenes.”
After they delivered the recommendation to Leavitt, the
secretary convened a first-ever special AHIC meeting by conference call on Nov.
28 — just 15 days after the Chicago meeting — and the board quickly adopted the
proposal. Leavitt drafted the letter and delivered it to Senate Finance
Committee chairman Max Baucus of Montana and ranking Republican Charles
Grassley (Iowa) the following week.
“It shows [that] when there’s linkage and alignment, things
can get done,” Gelinas tells Digital
HealthCare & Productivity.
Now it’s up to Congress to act. Anyone who follows health-IT
knows that that’s far from a sure thing.
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