2014 EHR Mandate

I have often found doctors talking about the 2014 mandate for adoption of EHR software. In fact, this post was inspired by a bunch of people searching online for the term “2014 EHR Mandate.” I think that they found my site because I previously did this post about Obama’s goal of Full EHR adoption by 2014.

If I’m remembering right, this was actually just an extension of Bush’s goal of having 100% EHR adoption by 2014. Obama took Bush’s original EMR aspiration and kept it going.

Although, I do have a real problem with people who like to call it an EHR mandate. It’s really not a mandate. A mandate for me implies that you are required to do it or there’s some grave consequence to it. It’s not like you’re going to be thrown in jail for not using an EHR or not be able to practice medicine if you don’t use an EHR (although some have hinted at this idea). Certainly the HITECH act has provided some Medicare penalties that could be considered a grave consequence to not adopting an EHR. Although, when you consider this example of the Medicare penalties it doesn’t look all that grave of a concern to me.

What other penalties are there to not adopting an EHR by 2014?

There certainly are other potential issues with not adopting an EHR that are worth considering:
1. Ability to Sale Practice – I don’t think we know all the details of how this will play out, but be sure that many younger doctors are going to want to purchase a practice that has an EHR. The common thinking I’ve seen going around is that a practice will be more valuable if it is electronic.

2. Government Mandated Reporting – While the government can’t really mandate the use of an EHR, it seems reasonable that the government could require certain reporting be done. Of course, you could manually do this reporting, but at some point the manual way will be much harder than using an EMR where the reporting can be automated.

3. Reimbursement Requirements – At some point the insurance companies are going to require their data electronically. So, if you’re going to want to keep accepting insurance, then you’re going to need to be electronic. I think the insurance companies are still watching and waiting to see what happens with meaningful use before they decide how they’ll approach it. However, you can be sure that they want more data and electronic is the way to make that happen. Of course, you could always go back to cash pay if you don’t like it.

4. Patients – It hasn’t happened quite yet, but get ready for a new patient base that wants their doctor to be electronic. No, you won’t have a “Got EMR?” sign outside your office to market to patients like we once talked about on EMRUpdate. It will come in more subtle things like the ability to schedule an appointment online. The ability to request refill requests electronically. Not having to carry (and possibly lose) their prescription to the pharmacy and then wait for it to be filled. Not having to fill out the same paperwork over and over and over again. Once patients get a real taste for these features, they’re going to be more selective in the doctors they choose to use.

5. ROI for Your Practice – There are plenty of arguments for and against the use of an EMR from an ROI perspective. I personally side on the positive ROI side based on this list of potential EMR benefits. Certainly it takes a smart EMR selection process and a well done EMR implementation to achieve the ROI, but I know a lot of people who’ve saved a lot of money thanks to their EMR. Add in things to come like doctor liability insurance discounts and the ROI will get even better over time. I know one practice who was having tough times financially. Their implementation of an EHR helped to solve some of those financial issues.

I’m sure there are plenty of other reasons that could “force” you to move to using an EMR. Of course, this CDC study on EHR adoption says Physician EMR use is at 50%. Although, in that link I use their study to show that it’s probably closer to 25% EHR adoption. Either way, we still have a long way to go to achieve Obama’s dream of 100% EHR adoption by 2014.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Clearly I haven’t read the bill either, but in part 2 of a 3 part 2010 CRM News article http://preview.tinyurl.com/4vk5uw6 it stated:
    “All healthcare providers would need to utilize EHR systems that met federal certification standards. In general, compliance by healthcare providers would be required by the end of 2015. In 2016, penalties for noncompliance would begin.”
    This article maybe irrelevant today, and this wouldn’t be the first time I misunderstood something that caught my attention…

  • packets,
    The article that links to seems to be the HITECH act penalties which I talk about above as Medicare penalties. I forget exactly when the HITECH act passed. Was that Obama or Bush? My how time flies and dates run together (at least for me). Doesn’t really matter though. Check out the link above about the insignificance of said penalties (linked here for easy reference: https://www.healthcareittoday.com/2010/10/12/example-of-emr-stimulus-medicare-penalties/ )

  • Curious and confusing, when they “mandate” EMR, does that entail all records (i.e., information) that a healthcare provider has acquired, which must be digital (no paper) and therefore controlled?
    The following article specifically references “personal, but non-medical information” being exposed like it was less of an issue…aren’t health insurance provider records a part of an EMR/PHI, what am I missing? And if it wasn’t such a big deal, why am I reading about it?
    6,500 Blues members’ personal info exposed

  • Physicians are controlled by CMS because most accept Medicaid… for now. When one works for the government, one must obey intrusive rules that harm patients. Bad ideas like “eHR mandates” don’t make it to dental offices because very few dentists tolerate the interference in their businesses, much less the fees that don’t cover the cost of providing care.

    I’ve pointed out before that eHRs in dentistry do not provide ROI, do not improve dental care and needlessly endanger dental practices as well as patients.

    So if we still live in a free nation, an eHR mandate is no more compelling to me to purchase something I don’t want than a cheap advertisement for a lousy product.

    Seriously. Do you really think it is the right of the federal government to stop me from practicing dentistry just because I prefer to keep records on safe, reliable paper? Let’s hope not.

  • packets,
    Hard to tell exactly what happened from that article. In fact, it’s the problem with most articles about HIPAA violations or breaches.

    Insurance companies certainly have some PHI, but not all that they have would be considered PHI. So, it would depend what they had compromised.

    Good question about why you’re reading about it. Although, some organization choose to disclose just in the name of good faith to their customers.

    D. Kellus Pruitt,
    I think it’s unlikely that we’ll see where it’s a true mandate. Although, they could make conditions that would essentially require its use. Although, even that is far away I think. Free markets are better IMHO.

  • As both a health care worker, and patient, I have privacy concerns. Is there a “foot print” on every person or agency that has accessed your EHR. Will you be able to monitor this on a regular basis, and question the validity anyone that has logged into your medical records?

  • piper,
    Each EHR is a bit different, but there are rules and extensive audit modules in EHR software to know who accessed what when. Might not stop inappropriate use just like a paper chart doesn’t, but at least then we can hold people accountable since it’s tracked. This is a step forward over paper charts unless you do fingerprint testing or catch them in the act.

    So, it’s good to address privacy concerns, but I think overall the EHR is a step forward in privacy in most cases.

    If you’re concerned about privacy, then don’t search on HIE though.

  • Since I have worked in the medical field and have worked with systems such as this they are a blessing. Many times a physician needs a record in the middle of the night when the patient comes to the ER through the hospital portal records can be obtained. Allergies, previous surgerious, previous medical conditions, etc can be seen. Also larger hospital systems already use systems such as this and they work well. No longer do you have to carry your records from physician to physician wasting valuable time going from previous hospital, physical, etc, and then taking them to your new physician paying maybe a fee for physicians request. The records belong to the physician not to the patinet they do not get the original, nor do they receive the original reports. What if a person has a MRI, x-ray, etc and the report is needed with short notice. You have no idea what is it like to call another facility and wait, and wait, and wait for a report to come through while a patient is lying in pain. Also through the system it could be possible to monitor prescription concerns such as people who use multiple physicians to receive pain medications this system would be able to track who has given them medications and whether or not they should be given another prescription or not.

  • I have worked in the medical field since 1995 and have written a program that converts some older NSF formats to HIPAA Compliant 4010A1. When my customers ask whether or not they MUST go with an EHR system, my stock answer is “When I spoke with CMS I was informed that they would not dictate to the doctor as to how to run your business. HOWEVER, if CMS is saying that they want everyone to be on an EHR system by a certain date, that is an indicator to me that they are going to start requiring information for claims adjudication that can only be captured by an EMR system. For example, you bill a diag for fever, what was the temperature?” The Government may never say outright that you MUST run your business in a certain way, but the can (AND WILL) demand that you provide certain information if you are going to do business with them (Medicare, Medicaid, etc.)

    One other comment about the salability of a practice. I have found that a practice is just as salable without an EMR system. The new doctor often times does not like the EHR package that was chosen.

  • Mandate in this case means; ifyou don’t do EHR you will not be able to see any doctor and doctors will not be able to see you. Because everything will be EHR and you will have to have the chip, hand scan and the Real Id. This will be a paperless world in other words do or die. Sounds like REVELATION TO ME. The WORDS AND WARNINGS FROM THE LORD AND GOD ALMIGHTY THE KING JESUS CHRIST; THE LORD IS MY GOD!

  • “Those who are not compliant by 2014 will lose federal subsidies and be penalized with diminished medicare and medicade payments.” My dorctors office is getting compliant and they said they will not be able to see any patient that don’t refuse to get their hand scand at their office at the time of their visit. Obamacare has a chip mandate and this is why the mandate as well without the chip you will not get health care. Key in “chip obama care.” Also I read the bill it is in there.

  • Amended statment: I mean refuse to get their hand scand for the visit. Also, I went in to have surgery at the hospital and they requested me to scand my hand. I said hell no; the woman at the front desk said it is your choice for now; this was last year.

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