Why is there disconnect between laboratories and electronic health records?
On one hand, we've got the Centers for Disease Control and Prevention (CDC) lamenting the EHR errors attributable to labs. One of the CDC's lead health scientists has warned that the lack of clinicians' involvement in EHR design--such as differing ways of displaying lab data and the use of inconsistent codes for the same lab tests--are contributing to patient safety issues. This is on the heels of a recent CDC report recommending that lab professionals be more involved in EHR development and implementation, help guide and maintain data integrity and usability of lab data, and be a greater part of improving the quality of healthcare.
On the other hand, pathologists don't seem enthusiastic. Or at least if they're willing to heed the CDC's call and become more involved with EHRs, they don't want to be shackled by the Meaningful Use program in order to do so.
The College of American Pathologists gained the support of 89 House lawmakers, who sent a letter to CMS head Marilyn Tavenner July 10 urging the Centers for Medicare & Medicaid Services to exempt pathologists from the incentive program for the next five years, the maximum amount allowed by the American Recovery and Reinvestment Act. The letter points out that CMS has already set this precedent when the agency granted pathologists--as well as radiologists and anesthesiologists--a one-year hardship exception in the 2012 rule establishing Stage 2 of Meaningful Use.
And that's on top of a bill introduced by Rep. Tom Price (R-Ga.), an orthopedic surgeon, that would exempt pathologists from the Meaningful Use program altogether. The bill, sitting in committee, is similar to one that Price introduced in the last legislative session.
I understand the pathologists' concern with the Meaningful Use program. It's arguably geared more to office-based physicians who have more direct face-to-face contact with patients.
But according to at least one survey, pathology is one of the specialties with the greatest use of EHRs. The Office of the National Coordinator for Health IT itself recently noted that the majority of lab results are shared electronically. And with the new rule removing patients' barrier to obtaining their lab results directly from labs, labs now will have a much better opportunity to directly interact with patients.
CMS has been pretty explicit about its viewpoint. In the 2012 rule granting the one-year hardship exemption from Stage 2, the agency noted that the exception is subject to annual renewal, but that the three specialties should not expect it to continue indefinitely. CMS also said it would consider if increases in health information exchange or other developments would apply to the three specialties.
So should pathologists be granted a break and receive a five year hardship exception or be dropped from the program entirely?
And why single out pathology for special treatment? Why aren't the lawmakers championing the anesthesiologists and radiologists? That strikes me as odd. Do the pathologists have a better case? Or are they better at lobbying?