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 forMedicare and Medicaid Services (CMS). The board‑certified physician, including the oncology specialist, isincluded in the list of eligible providers, and even a small practice of just threephysicians can receive more than $100,000 from the Health InformationTechnology for Economic and Clinical Health (HITECH) Act, a set of mandatesthat falls under the stimulus provisions of the American Recovery andReinvestment Act (ARRA) of 2009.1
The topic is of some immediacy, because eligible providers need to qualify soon in order to receive the full incentivesand avoid penalties. ChantalWorzala, writing in the Journal ofOncology Practice, warns that, “The Medicare EHR incentives have the forceof law and will be implemented on an aggressive timeline.”2 Thismeans that oncologyphysicians who fail to jump on the bandwagon and adopt the EHR very soon willfeel the pinch of the penalty provisions of the same HITECH Act, which reduceMedicare payments for practices, hospitals, and other health providers that donot adopt the EHR technologies. Forproviders that fall behind, payments will be decreased by 1% in 2015, 2% in2016, and 3% in 2017.3
The oncologist andteam are positioned well to participate in the adoption of an appropriatesystem that adds value and improves patient care. The EHR technology specifically addsvalue in the areas of chemotherapy ordering, preparation,and administration.4 In atwo-part review published in the Journal of Oncology Practice, Shulman andcolleagues note that, “EHRs hold the promise of enhancing our ability todeliver safe and quality oncology care. However, as with any technology,integration into the clinic must be accompanied by a careful assessment ofworkflow and with great forethought.”5 Shulman and coworkers review some generalprinciples important to the productive integration of the EHR into the oncologypractice:
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- 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)
