Dermatologists should think long and hard about costs and potential benefits before attempting "meaningful use" under the Centers for Medicare and Medicaid Services' electronic health record incentive program, according to Dr. Daniel M. Siegel, president-elect of the American Academy of Dermatology.
The program, launched in January, offers payments to physicians for using health information technology to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program, he reported at the Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation (SDEF).
Dr. Daniel M. Siegel
But the payments don't necessarily make up for the added work, said Dr. Siegel, clinical professor of medicine at State University of New York (SUNY) Downstate in Brooklyn, N.Y. For example, the criteria ask physicians to report on items that most dermatologists don't deal with, such as body mass index and vaccinations. Physicians can opt out of items they never perform, but if they occasionally do them, they must report on them often enough to meet the government-established criteria.
For example, if a dermatologist occasionally takes vital signs, they must be reported for more than 50% of all unique patients aged 2 and older, as structured data, to qualify for the incentives. "It really can be a big hassle," he said in an interview.
The decision about whether to participate in the program should be made on a practice-by-practice basis, he said. For those physicians who already have certified EHRs, it probably makes sense to participate, at least this year, for the 90 consecutive days required. For others, it may be less expensive to accept the 1% penalty that begins in 2015 than it is to purchase and implement a system that could slow down work flow in the office. For someone who is retiring in the next 5-7 years, it would be more expensive and more time consuming to participate. "They're not really offering you that much," he said.
The key, Dr. Siegel said, is not to be intimidated. And don't expect that the program will remain the same. This is the first year that physicians can qualify for incentives under the program, but penalties won't go into effect until 2015. By then, there will have been two congressional and one presidential election. "There is a good chance that some of these things could be parceled away," he said.
Dr. Siegel is a consultant with Encite, Logical Images, and Vivacare and is a shareholder in DermFirst. SDEF and this news organization are owned by Elsevier.