Hospitals say funds to encourage digitization of medical records come with too-strict rules

In February 2009 the Obama administration made available tens of billions of dollars to help doctors and hospitals buy equipment to computerize patients’ medical records, but now some of the country's top medical facilities are joining with smaller hospitals in saying the initial eligibility rules for the funds are too strict. "Doctors and hospital executives, who have expressed their frustration in meetings with White House and Medicare officials, said the issue offered a cautionary tale of what could happen when good intentions meet the reality of America’s fragmented health care system," Robert Pear of The New York Times reports.

The funds are distributed through Medicare and Medicaid as incentives to use electronic records, and when the law was passed the Congressional Budget Office estimated that the incentive payments would total $34 billion. "It is no surprise that tiny hospitals in the Midwest and doctors practicing by themselves would grumble about the White House proposals," Pear writes. "But elite institutions have similar concerns." Institutions like Kaiser Permanente, Intermountain Healthcare and the Mayo Clinic have voiced concerns about the requirements.

"At this date, Intermountain could not meet 36 of the 48 meaningful use requirements," Dr. Brent E. Wallace, chief medical officer at the Utah-based company, which President Obama has pointed to several times as the shining example of health care done right, told Pear. "To qualify under the administration plan, doctors would have to meet 25 criteria, or objectives, and hospitals would have to meet 23," Pear writes. Jonathan D. Blum, deputy administrator of the Centers for Medicare and Medicaid Services, told the Times, "We want to strike a balance. We will provide flexibility for doctors and hospitals, but push them to elevate their performance. Final rules will be out in early summer." (Read more)

Unsure of how the administration's programs will affect them, many in rural health care have been skeptical of the switch to electronic records, Teryn Schaefer of KOMU-TV, the University of Minnesota-owned station, reported earlier this month. But some like Dr. Karen Edison, director of UM's Center for Health Policy, say "Electronic records are the future and that rural health care will have to convert soon or later and they are there to make it happen," Schaefer writes. (Read more)