Health care reform affects physicians in many ways, but perhaps the most immediate effect is the pressure to buy and use an electronic health record (EHR) system. Recommendations on EHR use were addressed July 27 in the keynote address of the Health Information Technology (HIT) Session.

David Hunt, M.D., chief medical officer at the Office of the National Coordinator for Health Information Technology presented "A Meaningful Question: How Regional Extension Centers (REC) and State Medicaid Directors Can Contribute to Maximize Adoption."

Many barriers to adopting an EHR exist, Dr. Hunt said, including lack of capital, uncertainty on the return on investment, finding a system to meet your needs, concerns about system obsolescence and the loss of productivity during the transition to using an EHR.

To help ease the transition, the U.S. Department of Health and Human Services (HHS), which oversees the Office of the National Coordinator, has established 62 regional extension centers to offer technical support. Each state has a regional center, and larger states have more than one.

"But at the end of day, we need more than a policy of good intentions," Dr. Hunt said, adding that two funding programs have been established to help physicians purchase an EHR system.

Two programs stand out — one from Medicaid and one from Medicare. The better deal for NMA physicians, he said, is the Medicaid program, which will reimburse physicians up to $63,750 over six years. The Medicare program offers a maximum of $44,000 in reimbursement. Another difference is the Medicaid program does not have a starting date, while the Medicare program requires physicians to purchase a system this year or lose reimbursement dollars.

"Twenty-one states have started the Medicaid dollars flowing," Dr. Hunt said. "Check the Medicaid website to see if other states are starting to implement programs, too."

Other efforts to support the use of EHR are also growing, he said. More than 20,000 people are being trained to help medical practices implement EHR systems. Also, almost 500 EHR vendors are operating, and five of those firms have been certified.

Much has been written about "meaningful use" of EHR systems to qualify for reimbursement, but meaningful use is not difficult, Dr. Hunt said.

"To be a meaningful user is easy. Buy the software and just use it. Use it every day," he said. "If you write prescriptions, use it to write prescriptions. Use it to do daily documentation of the patient's care."

Despite all the discussion about cost and learning to use electronic medial records, there is one overriding reason to implement an EHR, Dr. Hunt said.

"This is all about giving you the tools to take better care of your patients," he said. "We still handle information as isolated factoids with little or no connection to each other. Our patients need so much more right now."