Paperless in Heathcare: The Carrot and the Stick

By Bob Larrivee posted 08-19-2011 13:37


I was thumbing through this week’s InformationWeek magazine and ran across an ad promoting the Centers for Medicare & Medicaid Services (CMS) incentives for professionals and hospitals who can demonstrate meaningful use of certified electronic health record (EHR) technology. The way this breaks down in a simply stated manner is that as an eligible healthcare professional or organization you register for the appropriate program and apply for funding to help in your migration to a paperless world. This is the carrot.

This ad brought to mind a discussion I recently had with my Family Practitioner who has made the move toward paperless. He told me he had spent to date, $250k to migrate over to a digital solution. While he likes this move, he still has the same number of office personnel to address the non-converted patient information, deal with the entities who are not digital as yet, and has found that when he is forced to provide paper to or communicate with firms or organizations like pharmacies, radiological facilities and others via fax or other means considered non-digital, it counts against him as being non-compliant, thus the reference to the stick in my story. How can this count against the organization that has made the investment and taken the steps to comply with the requirements of going digital when they have no control over those they deal with? This would imply that regardless of quality, my Doctor should only deal with those who have gone digital in order for his practice to comply and meet the requirements.

While this may seem like an exaggeration on my part, when it was explained to me by my Doctor - and yes we do discuss these things for which I am grateful and find it very enlightening – I found his level of frustration very high. I can't say I blame him. He has made the investment and taken the time to move forward yet he is being penalized for things beyond his control.  Who wouldn’t be frustrated?

In my view, the idea of going paperless is a sound one even if it translates to minimalized paper use rather than complete elimination of paper. (We have been trying since the 1980s.) I do feel however, that if incentives are the carrot, the carrot should be provided to those who have made the investment and demonstrated compliance internally. The carrot turns to a stick when you are denied due to the non-compliance of those not under your control. I am sure there are reasons for this but to me, it just seems demotivating. Can the world go paperless? Maybe. Should we make an effort in that direction? Absolutely. Should there be incentives attached? Why not? Just make it fair and reasonable.

If as an organization, you are ready to move forward and are finding yourself stuck or unfocused and are not sure where to begin or what to do next, seek professional assistance and/or training to get you started.

What say you? Do you have a story to tell? What are your thoughts on this topic? Do you have a topic of interest you would like discussed in this forum? Let me know.


Bob Larrivee, Director and Industry Advisor – AIIM

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I will be teaching the AIIM ECM Master class in Philadelphia September 13-16 and will be speaking at the following events:

Sbcon11 Virtual Conference on September 8, 2011

ARMA’11 in Washington, DC – October 17-19, 2011


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