Electronic Health Records

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Electronic Health Records
Electronic Health Records

Oncologists who make the switch from paper documentation to electronic health records (EHR) now are eligible for cash incentives of up to $44,000 from the Center for Medicare and Medicaid Services (CMS).   The board‑certified physician, including the oncology specialist, is included in the list of eligible providers, and even a small practice of just three physicians can receive more than $100,000 from the Health Information Technology for Economic and Clinical Health (HITECH) Act, a set of mandates that falls under the stimulus provisions of the American Recovery and Reinvestment Act (ARRA) of 2009.1

The topic is of some immediacy, because eligible providers need to qualify soon in order to receive the full incentives and avoid penalties. Chantal Worzala, writing in the Journal of Oncology Practice, warns that, “The Medicare EHR incentives have the force of law and will be implemented on an aggressive timeline.”2 This means that oncology physicians who fail to jump on the bandwagon and adopt the EHR very soon will feel the pinch of the penalty provisions of the same HITECH Act, which reduce Medicare payments for practices, hospitals, and other health providers that do not adopt the EHR technologies. For providers that fall behind, payments will be decreased by 1% in 2015, 2% in 2016, and 3% in 2017.3

The oncologist and team are positioned well to participate in the adoption of an appropriate system that adds value and improves patient care. The EHR technology specifically adds value in the areas of chemotherapy ordering, preparation, and administration.4 In a two-part review published in the Journal of Oncology Practice, Shulman and colleagues note that, “EHRs hold the promise of enhancing our ability to deliver safe and quality oncology care. However, as with any technology, integration into the clinic must be accompanied by a careful assessment of workflow and with great forethought.”5 Shulman and coworkers review some general principles important to the productive integration of the EHR into the oncology practice:

  • Accuracy
  • Standardization
  • Automation (e.g., of calculations)
  • Decision Support (with tools such as dose ranges, thresholds, and interaction alerts)
  • Flexibility (to incorporate new medical technology)
  • Workflow Integration (with support, allied health, and pharmacy staff)
  • Safety First (over convenience)
  • Efficiency (faster than paper)

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