At Mass General, internal financial incentives key to EHR, tech adoption

At Massachusetts General Hospital, a program offering modest financial incentives to salaried physicians went a long way toward helping the facility to meet goals for electronic health record adoption, improved quality and efficiency and communication with patients.

According to a report published this month in Health Affairs, the hospital's Massachusetts General Physicians Organization (MGPO) Quality Incentive Program has good results to report after six years.

"Incentive programs like this--which can help organizations focus the attention of busy clinicians on tasks that help deliver better, more cost-effective care--are very valuable at a time when the health care system is transitioning from fee-for-service to new payment models," Timothy Ferris, medical director and co-author of the report, said in an announcement from the hospital. "One of the ways this differs from traditional pay-for-performance programs is that it was designed by physicians for physicians, who determined what the goals and priorities were." 

The MGPO Quality Incentive program was designed to focus on clinical priorities applying to all physicians in the program, and is funded by redirecting a portion of physician earnings. For example, measures related to adoption of an EHR system started with attending training sessions in the system, then timely incorporation of 80 percent--and then 90 percent--of outpatient notes into the system. Eventually, physicians were asked to complete final notes within eight days.  

"By setting realistic targets that were increased in an incremental way, we could introduce more demanding goals at a pace that physicians found tolerable," Deborah Colton, MGPO senior vice president and co-author of the report, said, according to the announcement. "We wanted goals that were important but also achievable, and hoped that physicians would meet the targets about 80 percent of the time. They actually exceeded our expectations, and 90 percent of the available funds were paid out over the six years."

Last January a report from research firm Frost & Sullivan determined that technology implementation would be key to growth in the preventative health space, despite "looming challenges" like reimbursement.

According to that report, a lack of provider incentives has slowed the technology adoption process, even though regulations and the economy continue to push healthcare professionals to incorporate some innovations--like electronic health records--into their care.

Financial incentive programs have struggled to gain motion in the past due to the Stark law and anti-kickback statutes, as a report from the Government Accountability Office stated last year.

To learn more:
- here's the Health Affairs abstract
- read the announcement from Massachusetts General Hospital

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