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  • Article Questions 'Rush' to EHRs

    A recent Boston Globe article explores some critics' claims that a government-incentivized "rush" to the adoption of electronic health records (EHRs) has created a new kind of patient safety issue with little oversight in place.

    In the July 20 issue of the Globe, reporter Christopher Rowland writes that "the explosion in the use of the electronic records has created the potential for efficiencies and safety benefits but also new risks for patients, the scope of which is still not fully understood." Rowland's lengthy article describes how $30 billion in federal subsidies aimed at encouraging these technologies "has thrust balky, unwieldy, and error-prone computer systems into highly sensitive clinical settings at a record pace."

    Rowland interviews proponents and detractors of EHRs—and a few professionals who are somewhere in the middle—and recounts findings from CRICO, "a Harvard-affiliated malpractice insurance group" that tallied rarely-reported cases in which the use or misuse of EHRs was thought to have caused harm.

    According to the Globe article, the CRICO study looked at a pool of approximately 5,700 cases cited in malpractice claims, and found 147 instances in which EHR problems resulted in adverse events. Of those 147 cases, 46 resulted in patient death. The article also describes 2 Boston-area cases in which some claim EHR-related problems contributed to the deaths of patients.

    The article does not include information on error rates or other problems linked to paper records.

    The Globe article follows a report in the June 20 issue of JAMIA, covered in APTA's PT in Motion News, that looked at the nature of problems related to use of EHRs in the Department of Veterans Affairs (VA) hospital system.

    APTA offers several resources on information technology and EHRs, including a webpage devoted to the use of EHRs.

    APTA Opposes UnitedHealthcare's Plan to Use Functional Reporting Requirements

    APTA is urging that UnitedHealthcare (UHC) stop its plan to implement Medicare outpatient therapy functional reporting code requirements in its Medicare Advantage plans.

    UHC announced its decision to implement functional limitation reporting in their May bulletin (.pdf, p.46). The company plans to require G-codes and severity/complexity modifiers on contracted physical therapist (PT) claims with dates of service on or after August 1, 2014. Claims that do not include the appropriate G-code and modifiers will be rejected.

    In its letter to UHC, APTA argues that the difficulties experienced by PTs during Medicare's changeover to the requirements, as well as limitations in data, make UHC's planned August 1 move ill-advised.

    APTA has its own functional limitation reporting webpage that provides resources to help members meet this reporting requirement.

    Proposed OPPS Rules Subject of New APTA Summary

    A new APTA summary focuses on proposed rules for the 2015 Medicare outpatient prospective payment system (OPPS).

    The PDF document includes information on payment impacts, ambulatory payment classifications (APCs), packaging policies for ancillary services, and other issues. The summary is part of an extensive set of APTA resources on Medicare coding and billing.