Many of the ways that EMRs relate to public health issues have been closely linked to government mandate, especially with the advent of Meaningful Use. Even before Meaningful Use, providers and EHR vendors were mostly in reaction mode, responding to the PQRS (formally PQRI) and the eRx (electronic prescribing) incentive programs. When I read the blogs of the large EHR vendors, I have noticed a persistent push-back on new regulations or requirements. Some of the resistance to follow the government’s lead is well deserved. There are at least 5 Meaningful Use Measures that were legislated as part of the HITECH Act that are confusing or “not ready for prime time”. I have also observed that, with Meaningful Use part 2 – due in 2013, many vendors are pushing for less change not more; we will blog on Meaningful Use 2 soon.
The real question is, why can’t EHR vendors innovate without government intervention or incentive? At MediTouch® our medical team believes we can. We recently demonstrated the way we lead innovation during a topical public health challenge, the Whooping Cough outbreak (in some states).
According to the Centers for Disease Control (CDC):
Pertussis (Whooping Cough) is an endemic (common) disease in the United States, with periodic epidemics every 3 to 5 years and frequent outbreaks. In 2009, nearly 17,000 cases of pertussis were reported—and many more cases go unreported. The primary goal of pertussis outbreak control efforts is to decrease morbidity (amount of disease) and mortality (death) among infants; a secondary goal is to decrease morbidity among persons of all ages.
From January 1 through December 31, 2010, 9,477 cases of pertussis (including ten infant deaths) were reported throughout California. This is the most cases reported in 65 years. In Michigan, an increase in pertussis was first observed in the second half of 2008, continued throughout 2009, and has continued to date throughout 2010. This is on top of a long term rising trend in the reported number of pertussis cases since about 1990. In Ohio, Columbus Public Health (CPH) and Franklin County Board of Health (FCBH) responded to an outbreak of pertussis during 2010. For 2010 year-to-date, there were 964 cases reported by Columbus and Franklin Counties.
Experts now recommend that adults and adolescents receive a Tdap booster vaccine to protect against whooping cough. It is especially important for those in contact with infants younger than 12 months of age. The Tdap booster is recommended, instead of the previously recommended Td (tetanus-diphtheria) booster. In many states, the Tdap booster is required before an adolescent can begin middle school in the fall. In fact, every physician in California recently received a reminder from the state’s public health officials regarding the immunization of adolescents, and the school requirements for this fall when the new school year begins.
Even though the recommendation for Tdap has changed, many of the standard quality measures have not been updated to meet the challenge of the recent Whooping Cough endemics, but MediTouch® has. Based on the new requirements, our medical team has responded and developed a clinical quality measure that works seamlessly with our Health Maintenance module. Now, every provider that opts in for reminders regarding our adolescent vaccine measure will be reminded to vaccinate their middle school age patients against whooping cough on time, for the start of school.
Our medical team’s responsiveness is a good sign for providers who use our system, or are considering adopting our iPad® friendly EHR. It proves that we have our eye on innovation. Innovation, not government regulation, is essential to the type of workflow enhancements that save practices money and generate revenue for the practice. The $44k – $64k in government incentives are just part of the positive economic impact of EHRs on provider practices. Ultimately, it will be the non-regulated innovation of EHR vendors that will transport the provider community to the EHR Promised Land – higher quality, lower costs, and increased revenue.
By implementing our latest clinical quality measure, Immunizations for Adolescents – updated for the latest requirements related to Whooping Cough, we prove that innovation means higher quality, lower costs, and increased revenue. Providers are now reminded at the point of care about the latest vaccine requirement, which translates into higher quality and reduced cost. In addition, their practices can use the opportunity to contact patients eligible for the vaccine during the summer months, when their practices tend to slow down a bit. Healthy patients, compliance with the latest vaccine regulations, and increased revenue – everybody wins. I’ll take innovation over regulation anytime!