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Aligning Incentives in Medicare

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In modern world electronic medical record (EMR) has created a revolution that has affected the entire system in the medical world. The EMR is a computerized medical record created in an organization that delivers care, such as a hospital or physician's office (The Institute of Medicine, 2006). This method has eased the process of data management, storage, retrieval and modification of data. As opposed to the paper based methods that are up to now the most used methods of recording patient information, electronic medical record provides flexibility and effectiveness going by the fact that this system does not need significant amount of storage space. For the relatively smaller medical facilities, EMR may strike out as an over-ambitious plan that may not go well with the budget line of these facilities. The essence for the adoption of the EMR is basically to increase data security and ensure that patient’s information can last for decades. In this sense, the undertaking by Dryden Family Medicine (DFM) to incorporate the use of EMR will go a long way in creating s steady transition of healthcare operations such as billing, prescription ordering as well as other routine processes.

Pay for performance is one of the emerging movements in health insurance aimed at encouraging better healthcare delivery initially in the US and Britain. Under this model, medical facilities, groups and other healthcare providers are rewarded for their efficiency in health care delivery. However, this has sparked a heated debate particularly in developed nations where critics question the applicability of this model. In these countries, it is very significant that large healthcare systems have shown great improvement in terms of healthcare delivery and efficiency. However, these large facilities fail in minimizing their cost with most of the resources being used in administrative expenses. This questions the pay for performance model where the efficiency of health providers is based on the cost effectiveness of the same facilities in delivering their services.

Pay for performance model has led to many medical facilities to try and engage better and complex systems in health-care delivery. In the US, most medical professionals and societies have over the years advocated for increased efficiency in the healthcare sector. This comes amidst concern over the criteria used to measure the degree of effectiveness by a healthcare provider. The pay for performance model therefore put most health organizations to task by initiating innovations and the adoption of new technology in healthcare delivery by healthcare providers while trying to provide quality healthcare. According to a recent study by the American Medical Association, the electronic medical records improve the overall efficiency of a medical organization by 6% annually. This explains why the pay performance model would undoubtedly encourage the adoption of electronic medical records by health providers.

In both the medical and professional world, cost benefit analysis maybe regarded as a system that deals with the decision making process. This can also be defined as the systematic process that details out what is to be done and why. Decision making process is a complex process that work under the assumptions that, an act should not be carried out unless its benefits outweighs the cost, the benefits and costs are weighed under a common denominator to establish their comparison with each other and the whole process is essential in improving cost benefit estimation for future projection. There are various advantages for the adoption of cost benefit analysis particularly when dealing with information technology adoption decisions. These advantages are such as the evaluation of the cost incurred in relation to the intended or projected benefits. However, the limitations of this method are that the IT sector is very dynamic. This implies that nit is not possible to weigh the decision making process under a common denominator such as cost. There is also the need to weigh the same under factors such as durability, complexity and time.

Before integrating the electronic medical records, the Dryden Family Medicine (DFM) should first ensure that the health facility’s internal and external environment can fully adopt the use of this new system. In this regard, one of the first measures is to educate the staff regarding the use of the EMR going by the fact that this facility had no IT support person except the IT manager. It is also evident that the facility due to its size was somehow limited on its budget implying that it could not hire outside consultants hence the more need to develop an internal consultant and cut on the cost incurred. Before the adoption of EMR, Dryden Family Medicine (DFM) should also ensure that the main servers in data encryption are safe. This is as a result of the fact that the EMR system has received sharp criticism over the security of data. In this, critics argue that the increased portability and accessibility of EMR increases the ease in which unauthorized people can access private information.

One of the key challenges faced by small health facilities as compared to large healthcare providers in relation to the adoption of HMIS projects such as EMR implementation narrows down to cost. Most of these small healthcare providers operate on a limited budget that greatly affect the adoption of such HMIS initiatives. More significantly, incentives are being aligned with performance with most people questioning the information systems used by health facilities to collect data valid for quality assessment. It is a fundamental fact that small healthcare providers will always feel much of the effect by adopting such HMIS initiatives. According to a recent study, more than 90% respondents from relatively small healthcare providers admit lacking substantive support form EMR providers. In addition, most of them agreed that the additional cost from EMR vendors and consultants is the key reason behind the late implementation of the system.

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