With WHO’s mandate for the adoption of electronic health records, experts in the healthcare industry feared that it would lead to fraudulent billing and coding tendencies. However, recent reports show that such fears are baseless. The report is based on the outcome of the researchers by Harvard School of Public Health and Michigan School of Information.
Healthcare organizations in USA became more aware of the meaningful use of EHR solutions after the HITECH Act was passed in 2009. It is reported that more than 5,000 hospitals in the country either adopted or attained the eligibility for receiving financial aid for the adaptation of Electronic Health Records solutions after the passage of the law. Initially, there was a concern that hospitals might manipulate the eligibility criteria for getting the financial aid. But, the reports show that all of the hospitals that became eligible for the financial aid were genuinely qualified.
Concerns about up-coding prevails
Meanwhile, a group of experts who studied the recent trends of adoption of EHR solutions in healthcare organizations and how they are being used expressed their concern over using web based electronic health records software to manipulate certain records. To highlight their point, the experts shed light on up-coding practices. Up-coding is a practice used by some medical billers to bypass the tedious process of billing.
In up-coding, the records of certain patients are copied and pasted for a group of patients. In such cases, the sicker patients often get unnoticed or don’t receive their deserving attention. The end result of up-coding is that the government ends up paying more amounts for healthcare issues that actually didn’t occur at all.
The reports by Harvard School of Public Health and Michigan School of Information have rightly identified the potential chances of up-coding, but have suggested solutions to prevent such fraudulent practices. The report suggests that frequent monitoring and periodical monitoring could curtail the chances of up-coding.
The report by both universities shows that there is no clear empirical data to show that holistic adoption of electronic health records would cause a staggering number of up-coding cases in healthcare organizations. The report encourages policymakers to ensure complete adoption of EHR solutions in hospitals that come under their jurisdiction.
The fast pace of transition from traditional health recording to Electronic Health records is a good sign. USA has a record in the number of public sector hospitals having been adopted EHR solutions as compared to other countries.