EHRs Neglecting Preventative Care, Health Promotion

Current e-health record software fails to help clinicians identify patients who need additional services, finds government report.
There are also barriers to adopting PBPH, which include the need for technological innovation, greater availability of usable data, new methods for reimbursement, changes in physicians' views of care delivery, and alterations in practice workflows.

"Several of the 27 providers we interviewed said either that they were unable to find systems that include population management functionalities or that the products they had purchased are not living up to their expectations in performing these management tasks," the report said,

Most respondents also said they are not actively seeking the tools needed for PBPH, leading the report to conclude, "with this lack of provider demand there is little incentive for vendors to create tools to support these functionalities."

To encourage the adoption of software that can track population health at physician practices, the report said current reforms to the healthcare system may provide opportunities to change the reimbursement structure for primary care.

"Reimbursement with a greater emphasis on outcomes could provide additional resources and incentives for primary care practices to engage in PBPH. Increased provider demand would probably motivate IT vendors to develop applications that support population management. Healthcare reform may also support models like the patient centered medical home, of which PBPH is a component," the report said. Another option could be to make PBPH functionality part of the requirements in the Medicare and Medicaid incentives program for providers who demonstrate meaningful use of EHRs, introduced in the American Recovery and Reinvestment Act (ARRA). This could spur the development of technology that supports a PBPH care approach.

"PBPH could most directly be supported by this legislation if PBPH functionalities are incorporated into those criteria. ARRA could also increase the amount of information available in electronic form by boosting EHR adoption and health information exchange nationwide. Finally, the ARRA-funded extension centers could provide training to help providers engage in PBPH," the report said.

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