Senate Hearing On EHRs And ICD-10 Reveals Skepticism

By Megan Williams, contributing writer

The success of EHRs through Meaningful Use, and ICD-10 efforts came into question in a Senate Appropriations Subcommittee hearing on April 23.

HHS Secretary, Sylvia Burwell weathered questions from both parties about challenges on both fronts. A statement from Senator Lamar Alexander summed up the frustrations in his statement, “The government has spent $28 billion subsidizing electronic health records. But, half the doctors are choosing not to participate in the program. Instead, they’ll face Medicare penalties this year. Doctors don’t like their electronic medical record systems by and large. They say they disrupt the workflow. They interrupt the doctor-patient relationship and they haven’t been worth the effort.”

Senator Alexander also pointed to a study by RAND Corp that pointed to EHRs as the leading cause of “professional dissatisfaction, emotional fatigue, depersonalization, and lost enthusiasm,” according to Health Data Management. He also told Secretary Burwell that he and ranking member Senator Patty Murray (D-WA) would be collaborating in a working group tasked with identifying five or six EHR problems that could be addressed administratively or legislatively.

Burwell responded to questions of the prioritization of EHRs in the remaining 17 months of the Obama administration with a statement of commitment and preparedness, “…we are looking forward to putting the list [of EHR issues] together and looking forward to getting it done. We’ll look at our administrative things and we want to work with you all on what we need legislatively as well.”

On ICD-10

ICD-10 received similar treatment, with Senator James Lankford (R-OK) expressing concerns about issues around the transition from ICD-9 to -10. He expressed worries over a less-than-smooth transition, serious claims processing issues, and cash flow disruptions…disruptions that would particularly impact smaller providers.

Burwell responded stating that only a small group of providers still wasn’t prepared, but that the Department of Health and Human Services (HHS) would be working with them until October. She also stated that hospital association surveys reveal large levels of preparedness among those questioned.

Senator Bill Cassidy (R-LA), M.D. said that he was still more concerned about small practices and cited Centers for Medicare and Medicaid Services (CMS) estimates of increases in denial rates from 100 to 200 percent and days in AR increasing from 20 to 40 percent … numbers that smaller practices simply can’t afford. He recommended that CMS delay the penalty phase for two years to accommodate transition.