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AOA Launches EHR Preparedness Program

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 box on page 6).

“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 $44,000 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 for 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/HIT.xml).

AOA Continues Push for Health Care Reform Priorities

As controversy continues to swirl around the Washington, D.C., debate over national health care reform legislation, the AOA continues its around-the-clock efforts to stop any unfair new restrictions on patient access to eye and vision care. While President Obama and Congressional leaders work to resolve differences between separate U.S. Senate and House-approved health care reform bills, the AOA Washington office team and concerned ODs and students from around the country have kept up the pressure on Capitol Hill to make optometry's voices heard and priorities known.

Throughout the process, a key objective for the AOA has been to ensure that provider non-discrimination safeguards to protect patient access to care make it through the Senate and House — Sen. Tom Harkin's (D-Iowa) federal provider non-discrimination provision and Rep. Mike Ross' (D-Ark.) amendment to block preemption of state patient choice/provider non-discrimination laws — and are both included in any health care reform bill going forward.

The inclusion of both the House and Senate protections will serve to provide the strongest possible patient access to care protection as the health care system undergoes the changes envisioned by reform legislation now or into the future, said Advocacy Group Director Jon Hymes. However, insurance and medical groups have mobilized against these provisions in an effort to defeat the inclusion of provider non-discrimination protections and must be stopped.

Among other issues, the AOA has also been working with House and Senate leaders to advance the House-approved Medicaid provision sponsored by Rep. Jan Schakowsky (D-Ill.), which is aimed at providing full recognition of optometry in Medicaid. It seeks to ensure – through a federal mandate – that ODs and all of the care they provide are not unfairly targeted for cuts by states because of optometry's current “optional” status under Medicaid.

A Jan. 20 trip to Capitol Hill by a number of Illinois optometrists focused, in particular, on working toward advancing the Schakowsky full recognition of optometry in Medicaid provision. The group included: Arol Augsburger, O.D., president, Illinois College of Optometry (ICO); Peter Kehoe, O.D., AOA immediate-past president; Stephanie Johnson Brown, O.D., executive director, Plano Vision Development Center; and Vince Brandys, O.D., senior director for Government Relations, ICO.

Drs. Augsburger and Brandys are central to the Illinois Eye Institute (IEI), which is the principal clinical training facility for Illinois College of Optometry students and is located adjacent to the college.

The IEI sees roughly 90,000 patients a year, with one-third coming from the Medicaid population.

Dr. Johnson Brown heads a non-profit vision care service corporation that provides care for a large Medicaid population as well.
“As the national health care reform battle enters what is likely to be the final stages, the AOA remains totally focused on reading the fine print and doing what it takes to safeguard patient access,” said AOA Executive Director Barry J. Barresi, O.D, Ph.D.

“At every step of the legislative process, the AOA has worked to ensure that the concerns of ODs and our patients are heard loud and clear on Capitol Hill, in the White House and throughout Washington, D.C., and we will continue to do so as efforts to advance health care reform legislation continue now and into the future,” Dr. Barresi added.

AOA Offers Free Materials to Promote Save Your Vision Month

March is the AOA's annual Save Your Vision Month. This year's observance is focused on “healthy vision in the workplace,” reminding employees of the importance of regular eye care and safety.

New patient education pieces discuss the effects of prolonged computer and hand-held device usage has on the eyes and tips for preventing eye strain and visual discomfort; a second brochure highlights the proper selection and usage of eye safety wear for work and home environments.

The AOA is offering FREE materials to members to assist in their efforts in promoting Save Your Vision Month locally. The kit includes:

Tip sheet on how to promote in the community
Sample letter to send to human resources managers
Two patient information sheets padded in quantities of 50:
- Healthy Vision and Hand-Held Devices
- Healthy Vision in the Workplace
PowerPoint presentation for lunch time “brown bag” seminars
Template news release that can be sent to the local media

To receive a free-of-charge member kit, please send an e-mail to publicrelations@aoa.org.