A lack of input from emergency physicians is putting patients in harm’s way as hospitals rush to meet electronic medical record (EMR) requirements. The American College of Emergency Physicians (ACEP) released a report recently that indicated many hospitals select their EMR system without consulting ED providers. As a result, emergency physicians are reporting an increase in medical errors on EMR systems that they have not had the opportunity to try out before selection and implementation. ACEP mentioned communication failure, poor data display, and incorrect patient information as among the complaints plaguing EDs using unfamiliar EMR systems.
During a hearing before the Senate Finance Committee, former Medicare Administrator Mark McClellan, MD, recommended that Congress link physician pay with patient outcomes. Dr. McClellan believes that establishing such a link will improve CMS’ ability to better track quality outcomes. "The measures aren't perfect, so initially you might not have payment tied to performance on the measure, or you might only have a small percentage of payment related to performance on the measure," McClellan said. "But it's a step in that direction that I think is much better than telling clinicians to improve care but then paying them in a way that doesn't give them any resources to do it." Christine K. Cassel, MD, incoming President & CEO of National Quality Forum, echoed Dr. McClellan’s sentiments.
On June 21, a study called Emergency Care, Front and Center by J. Stephen Bohan, MD, MS, was published in Journal Watch Emergency Medicine. Bohan reports that there were “130 million visits to EDs in 2010, a 34% increase over 1995”. In addition, regarding hospital admissions “the national average admission rate is 18%, (and) in those aged 65 and older, it is 42%”. Bohan also reports on the growth in the cost of the average visit to the ED, which between 2000 and 2010 “rose from $546 to $949, a 77% increase”. He attributes a key factor behind this rise as “no doubt related in part to greater use of advanced imaging studies”.
As officials recommend linking physician pay with patient outcomes to improve quality, Senators Grassley (R-Iowa) and Wyden (D-Oregon) have moved forward with a bill that “would open up all Medicare claims to public scrutiny, noting that additional Medicare claims transparency could curb wasteful overspending.” If signed into law, the bill would require the Department of Health & Human Services (HHS) to publish and maintain a public website of searchable Medicare expenditures. Sen. Grassley hopes the bill will enhance accountability by enabling taxpayers to see “how their dollars are being spent,” with the ultimate goal of reducing costs.