HIT, and reimbursement, key to health reform

Many studies have come out claiming health IT is the key to restoring the healthcare system, but the latest report from the New England Healthcare Institute goes on to recommend reimbursement for providers’ phone and e-mail encounters with patients.

Entitled, "Remaking Primary Care: From Crisis to Opportunity," the report lists health information technologies as including EMRs, clinical decision support systems, computerized physician order entry (CPOE), online appointment scheduling, and secure messaging of test results.

"Properly implemented,” the report states, “HIT frees up physician time during visits, provides all members of the primary care team with timely access to patient information and aids in the overall coordination of care."

But because the implementation of these technologies takes substantial investment in both capital and personnel—and because the reimbursement gap and increasing provider dissatisfaction with the work is considered a driver of the primary care workforce shortage—the development of financial models that encourage adoption and best practices in implementation, use and maintenance of the systems are required.

With a nod to the increasingly mobile workforce healthcare providers comprise, the report adds that basic reimbursement for providers' time spent on phone and e-mail encounters with patients would be a major improvement to reimbursement policy.

In fact, given that many clinicians already provide these contacts without compensation, the report states offering reimbursement for phone and e-mail activities is “not only a matter of fairness, but will serve to support patient access and improve care continuity through communications mechanisms that are commonplace to most Americans.”

So, if health IT saves the healthcare system, reimbursing providers for on-the-fly expertise just may save our quality of care.