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The AOA is launching a new Electronic Health Records (EHR) Preparedness Program for Optometry to spur prompt implementation of EHRs in optometric practices and ensure optometrists are included in the nation’s rapidly developing EHR system.

“The emergence of a national digital health information technology (HIT) network could potentially be as important in the history of health care as the rise of third-party payment, managed care, or – in the case of optometry – the securing of pharmaceutical prescribing authority,” said AOA President Randolph E. Brooks, O.D. “Optometry as a profession, and optometrists as individuals, must be ready.”

Because EHRs have the potential to impact virtually all aspects of optometric practice, the AOA Electronic Health Records Preparedness Program is a comprehensive effort involving all of the association’s operating groups, said AOA Executive Director Barry J. Barresi, O.D. (see end of story).

“The objective is to make sure optometry has a voice in shaping the nation’s EHR system and EHRs can be implemented in optometric practices to enhance the care of patients,” Dr. Barresi said.

“Electronic health records are the future of health care,” said Philip J. Gross, O.D., chair of the AOA Health Information Technology and Telemedicine Committee, which is coordinating the EHR effort. “Far more than just an efficient way to record patient information or file insurance claims, EHRs hold the potential to revolutionize health care practice. They are important clinical tools with a range of functions that can be used to markedly improve the quality, safety, and efficiency of care; enhance care coordination; reduce health disparities among various segments of the population; engage patients and their families in care; and address critical public health issues.”

“Full utilization of EHRs will be essential if optometrists are to provide their patients the highest quality care,” Dr. Gross said. “Moreover, EHRs are central to virtually every major proposal for the improvement of American health care. For that reason, meaningful use of EHRs will be essential if optometrists are to continue as an integral part of America’s health care system.”

The AOA Electronic Health Records Preparedness Program is specifically intended to ensure optometrists:

• Qualify for the federal American Recovery and Reinvestment Act (ARRA) incentive program, which begins Jan. 1, 2011.
• Become part of the U.S. Department of Health & Human Services (HHS) Nationwide Health Information Network (NHIN), which is scheduled for launch in 2014, and
• Avoid Medicare payment penalties for practitioners who do not use EHRs, beginning in 2015.

The ARRA incentive program is intended in large part to encourage health care practitioners to implement EHR systems in time for the launch of the NHIN — through which the government plans to make electronic health records available to all Americans. The incentive program offers health care practitioners a unique opportunity to implement state-of-the-art EHR systems at reduced out-of-pocket cost, Dr. Gross said.

Under the ARRA program, up to $48,400 in Medicare incentive payments will be available to practitioners who achieve “meaningful use” of certified electronic health records.

The government incentives could cover much of the cost of implementing an EHR system, Dr. Gross noted. However, practitioners who are interested in the incentives must act quickly, he emphasized.

EHR systems can take a considerable period of time to implement in a practice, Dr. Gross noted. “Early adopters” will find it easier to qualify for incentives under program rules. They will also receive the largest total incentive payments. And the incentives will be in effect for only a limited period of time, Dr. Gross added.

The ARRA incentives are part of a “carrot and stick” approach to encouraging EHR use, Dr. Gross said. As the HHS begins phasing out the ARRA incentives in mid-decade, its Centers for Medicare & Medicaid Services (CMS) will begin decreasing Medicare payments 1 percent for practitioners who do not implement EHRs.

HHS rules prevent practitioners from receiving credit for EHR utilization under Medicare’s Physician Quality Reporting Initiative (PQRI) while participating in the ARRA incentive program. However, practitioners who implement EHRs during the ARRA incentive program will probably be able to report EHR use under the PQRI thereafter, Dr. Gross notes.

Implementation of qualified EHR systems can also help practitioners avoid Medicare payment penalties for failure to utilize e-prescribing beginning in 2012.

As part of the AOA Electronic Health Records Preparedness Program, the AOA Health Information Technology and Telemedicine Committee is introducing its “Enhancing Patient Care Through the Implementation of EHRs” continuing education course, which will outline the use of EHRs for the enhancement of clinical care in practice, the “meaningful use” criteria optometrists will have to meet in order to qualify for incentive payments, and functions required of certified EHR programs. The program will be offered primarily at state optometry association meetings.

“Countdown to 2011,” a new series beginning in the March edition of Optometry: Journal of the American Optometric Association, will outline practical strategies for the implementation of EHRs in optometric practices and detail the ARRA incentives.

A new electronic health records page on the AOA Web site will provide a “one-stop” EHR resource for optometrists with extensive background information, practical steps for implementation, and information on regulatory requirements (www.aoa.org/EHR.xml).

Electronic Health Records Preparedness Program for Optometry

• The AOA Advocacy Group is monitoring and taking part in the development of federal rules and regulations pertinent to EHR use.
• The AOA Communications Group is regularly updating member optometrists on EHR issues through the AOA Web site and AOA publications.
• The AOA Clinical and Practice Advancement Group in conjunction with the AOA Meetings Group is developing a new EHR continuing education course on EHR implementation in optometric practice. 
• The AOA Industry Relations Committee is working with software vendors and the Ophthalmic CouncilTM to make sure they have the latest information on the development of the EHR network – including the pending federal certification and incentive requirements – and ensure certified EHR programs are available to optometric practices in a timely manner.
• The AOA Third Party Center and Advocacy Group is monitoring the development of Health Information Exchanges (HIE) around the nation and working to ensure optometrists are prepared to take part in their local HIEs.