Implementing the HITECH Rules in Oncology Practices

April 2011, Vol 2, No 2
Gena Cook
Co-Founder & CEO
Navigating Cancer
Seattle, WA

Washington, DC—The American Recovery and Reinvestment Act (AARA) of 2009 provides up to $27 billion over 10 years for the Centers for Medicare & Medicaid Services to offer cash incentives to encourage providers to make the switch to electronic health records (EHRs), said Gena Cook, CEO, Navigating Cancer, a web-based company dedicated to oncology services.

Financial Implications
Speaking at the 2011 Association of Community Cancer Centers annual meeting, Ms Cook emphasized that the focus should be on “meaningful” adoption of EHRs for improving patient care, according to the ARRA.

Providers are encouraged to move quickly to understand the coming changes resulting from implementation of the AARA and the Health Information Technology for Economic and Clinical Health (HITECH) Act, which falls under it.

By 2015, providers who continue to use paper records instead of EHRs could have their Medicare reimbursements reduced, she said.

“What people aren’t thinking about is what that really means. As you adopt technology into your office, what does that mean for patients and their families?” she asked.

“This is a part of healthcare reform, where the train has already left the station. This has bipartisan support, and physicians can start…receiving payments this year.”

Addressing providers’ concerns about the cost of EHRs, she said it is better to reap the incentives now than get hit with penalties later. To receive federal funds, providers must demonstrate “meaningful use” of EHRs. The objectives constituting meaningful use will be implemented in 3 stages.

The 3 Implementation Stages
Stage 1, which has 20 objectives, has been released; it includes providing patients with a clinical summary and timely electronic access to records.

The objectives for stage 2 for 2013 may include implementing patient reminders, providing discharge instructions, and secure online messaging. Providers may be compelled to have 20% of their patients using web portals, Ms Cook said. Providers must ensure that a vendor is Health and Human Services–certified.

By 2015, stage 3 could require further patient engagement, electronic selfmanagement tools, EHR exchanging data with personal health records, among other objectives.

This process provides an opportunity to better engage patients in the treatment process. “Think about empowering your patient to be a part of care,” Ms Cook said.

Patient portals have already been implemented by some groups: 35% of Kaiser Permanente patients and 60% of Group Health patients now use the portals. “Not only do they give patients electronic access to their health information, but they give them tools to manage a lot of transactions within health,” Ms Cook said. “Their patient portals allow patients to request appointments, request prescription refills, and to do online consults for simple things.”

Patient–Provider Communication
Responding to a question on patients misinterpreting their raw medical data, Ms Cook noted that having EHRs does not mean giving patients access “to the entire chart” or their entire information.

Continuity-of-care documents and continuity-of-care records are becoming the standard for communication between provider and patient and between provider and provider.

Ms Cook cited a recent Pew Internet Research study (, which found that searching for health information is the third most popular activity online.

In addition, a study published in the Journal of Medical Internet Research showed that 75% of patients wanted online access to medical records, laboratory results, and appointment scheduling (Adler KG. Web portals in primary care: an evaluation of patient readiness and willingness to pay for online services. J Med Internet Res. 2006;8:e26).

Patient privacy and security are major concerns, and privacy advocates are pushing the government to take steps to strengthen data safeguards. But the HITECH Act makes EHRs a certainty, and providers should act proactively to implement a system that works best for their practice.

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