GAO: $30B Incentive Program Making It More Difficult to Share Electronic Health Records

by Barbara Hollingsworth

Source: CNS News

The federal government’s six-year-old, $30 billion Electronic Health Records (EHR) Incentive Programs – which were designed to cut medical costs by allowing doctors and hospitals serving Medicare and Medicaid recipients to share test results and clinical data – are having the opposite effect, according to a new report by the Government Accountability Office (GAO).

Representatives from 10 of 18 non-federal, non-profit participating organizations interviewed by GAO between April and September said that program requirements “divert resources and attention from other efforts to enable interoperability.”

As a result, the costs of trying to combine incompatible patient records is forcing medical costs up instead of down.

“Sixteen of the 18 initiatives are working to address the challenge of the reported high costs associated with interoperability,” GAO reported.

The EHR incentive program was funded under the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the 2009 stimulus legislation.

But Stage 2 of the program is so complex that only about 11 percent of the 491,000 eligible physicians and 42 percent of the nearly 4,500 eligible hospitals have been able to comply with it, according to Senate Health, Education, Labor & Pensions Committee chairman Lamar Alexander (R-TN), one of five Senate committee chairman who requested the GAO study.

Representatives from five of the groups interviewed “suggested pausing or stopping the programs” altogether because differing technical standards and variations in state privacy rules are making the goal of interoperability difficult to reach, the GAO reported.

“Some methods to match records for the same patient across providers can fail because of differences across EHR systems in data formats or because of missing data from or inaccurate data in some health records,” the report noted.

On Thursday, Sen. Alexander also urged the Obama administration to "take time to do it right," pointing out that medical providers face fines if they fail to comply with new Stage 3 requirements.

But critics point out that achieving EHR interoperability poses a threat to patient privacy.

“Given the absence of patient consent requirement for data sharing, the lack of interoperability is all that protects Americans from a nationally imposed breach of their medical privacy,” said Twila Brase, president of the Citizens’ Council for Health Freedom.

“If a personal, computerized medical record is considered so essential, why not simply scan anything pertinent onto a thumb drive for the patient, so he alone has control of it and can decide who will have access?” asked Lawrence Pivnik, MD JD, a contributing fellow with the National Center for Policy Analysis (NCPA).