Incentives for Health IT Might Be Shunned, Rather Than Embraced

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily.

“I don't think [health care] professionals have any idea what's coming,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society during a panel discussion at an eHealth Initiative conference. “[Federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that [doesn't] happen, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers could find that they don't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts, no one has figured out how to use information technology to get patients more involved in their care, said Dr. Lichtenfeld. “A couple of years ago, personal health records … were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has come to pass, he said.

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two work groups of the department's HIT Policy Committee.

Two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time,” he said.

Instead of requiring physicians to meet many criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” Dr. Stack said.

Ingenix, the American Medical Association, and several other industry groups sponsored the conference. The speakers reported that they had no relevant disclosures.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily.

“I don't think [health care] professionals have any idea what's coming,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society during a panel discussion at an eHealth Initiative conference. “[Federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that [doesn't] happen, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers could find that they don't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts, no one has figured out how to use information technology to get patients more involved in their care, said Dr. Lichtenfeld. “A couple of years ago, personal health records … were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has come to pass, he said.

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two work groups of the department's HIT Policy Committee.

Two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time,” he said.

Instead of requiring physicians to meet many criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” Dr. Stack said.

Ingenix, the American Medical Association, and several other industry groups sponsored the conference. The speakers reported that they had no relevant disclosures.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily.

“I don't think [health care] professionals have any idea what's coming,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society during a panel discussion at an eHealth Initiative conference. “[Federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that [doesn't] happen, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers could find that they don't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts, no one has figured out how to use information technology to get patients more involved in their care, said Dr. Lichtenfeld. “A couple of years ago, personal health records … were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has come to pass, he said.

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two work groups of the department's HIT Policy Committee.

Two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time,” he said.

Instead of requiring physicians to meet many criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” Dr. Stack said.

Ingenix, the American Medical Association, and several other industry groups sponsored the conference. The speakers reported that they had no relevant disclosures.