2009年3月25日 星期三

Stimulating the Adoption of Health Information Technology


Source: The New England of Journal of Medicine
Published at www.nejm.org March 25, 2009 (10.1056/NEJMp0901592)
Auther: David Blumenthal, M.D., M.P.P.



內容摘要:

美國醫療照護系統正如火如涂地展開,而改革計劃中最無爭議的一項就是病歷電子化。為了加速病歷電子化的工作,美國國會規劃以提供誘因的方式來達成預期目標。在規劃案中,明顯地國會希望把資訊科技是做為改善醫療品質的工具,因此財務誘因的評量標準是服務品質的改善,而非醫療環境電子化的程度。當然,在這過程中會有很多困難需要克服,但既然台灣已經成功完成全國病歷電子化的工作,美國當然也是能夠成功的。

"One of HITECH's most important features is its clarity of purpose. Congress apparently sees HIT — computers, software, Internet connection, telemedicine — not as an end in itself but as a means of improving the quality of health care, the health of populations, and the efficiency of health care systems. ..... "

"...the legislation's most important provision may be $17 billion in financial incentives intended to get doctors and hospitals to adopt and use EHRs..."

"HITECH also threatens financial penalties to spur adoption. Physicians who are not using EHRs meaningfully by 2015 will lose 1% of their Medicare fees, then 2% in 2016, and 3% in 2017...."

"...much will depend on the federal government's skill in defining two critical terms: 'certified EHR' and 'meaningful use.' ONCHIT currently contracts with a private organization, the Certification Commission for Health Information Technology, to certify EHRs as having the basic capabilities the federal government believes they need..."


"....By tying Medicare and Medicaid financial incentives to 'meaningful use,' Congress has given the administration an important tool for motivating providers to take full advantage of EHRs, but if the requirements are set too high, many physicians and hospitals may rebel — petitioning Congress to change the law or just resigning themselves to forgoing incentives and accepting penalties. "

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