Heslin, who had been asked to testify only the week before, had written seven minutes of testimony. How did he get that into the five minutes allotted to him? “I talked very fast,” he said with the self-assurance of the congenital overachiever. He admitted to having been nervous at the beginning of his testimony, his first appearance ever on a Washington stage.
Later in the day, Heslin drove back though Baltimore, stopping to have dinner with his mother. Then the local physician, who has been known to challenge the speed of sound driving his car on the open road, drove post-haste home to Saugerties.
He saw his first patient at eight the next morning.
“I like to do many things,” he said. “My favorite thing to do is to see patients.”
What did Heslin think about his experience in Washington after he had a chance to relax a little over the weekend? “I felt pretty good, actually,” he said. “I like to experience the new and the different.”
There’s no more passionate, articulate or fast-talking a local believer in the positive consequences of computerization of medical records than Heslin, also current chairman of the board of trustees of HealthAlliance of the Hudson Valley. He has been a leader in the region’s adoption of the new information technology in both primary-care and hospital settings. Some 46% of primary-care physicians in the Hudson Valley use such records, he said, as compared to 20% nationally.
“If a small general medical practice in Saugerties, New York can use new health-information technology tools to deliver safer, more efficient health care for its patients, so can practices across the nation,” wrote Forbes.com prior to Heslin’s congressional appearance.
One of the other panelists last Tuesday was Dr. David Blumenthal, national coordinator for health information technology in the Obama administration. Last year’s federal stimulus bill created Blumenthal’s office and gave him significant funding and power to determine what products provided “meaningful use” of information technology in health records.
“By purchasing certified EHR [electronic health records] technology, hospitals and eligible professionals and hospitals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives, and begin to use EHRs in a way that will improve quality and efficiency in our health-care system,” Blumenthal recently said. “We hope that all stakeholders view this rule as the federal government’s commitment to reduce uncertainty in the health information-technology marketplace and advance the successful implementation of EHR incentive programs.”
Heslin, an early adopter of EHR technology in his own practice, has been a persistent proselytizer for its use. A board member of a Fishkill-based regional network called THINC (Taconic Information Network and Community) that has in alliance with affiliated organization spearheaded the adoption of electronic health records, particularly by primary-care physicians, Heslin has pushed for rapid change in his profession. He believes that a local commitment to interactive technology will pay off in huge gains of efficiency in health care.
“We know how to practice medicine real well,” he said earnestly. “We don’t know the technology that we will need to integrate [this knowledge] into processes and do what we do more efficiently. Technology is just a tool to help the physician-patient relationship.”
One can’t say that Heslin has been reluctant to practice what he preaches.
“Heslin, who has used electronic health records in his six-physician practice since 2006, is on the leading edge of health-information technology adoption,” continued Forbes.com. “In 2009, Bridge Street Medical Group was among eleven practices with 237 primary-care physicians operating at 51 sites across the Hudson Valley that adopted the patient-centered medical home model and used health-information technology to support his practice redesign to this new approach to care.”
Medicare, Medicaid incentives
The long-awaited final rule for what constitutes meaningful use was released by the federal government on July 13. Beginning in October, billions of dollars in Medicare and Medicaid incentive payments will become available to health-care providers who can demonstrate “meaningful use” of EHRs. In Washington, Heslin testified about the role incentives will play as providers move to adopt health-information technology.
Heslin called the new federal regulations, a year and a half in the making, “great.” What was important, he said, was that they now existed. They can be changed. “The rules will evolve,” he said.
With the aging population, the number of persons on Medicare is expected to double over the next 20 years, the number of more complex patients will increase at the same time the number of primary-care physicians is projected to decrease.
Heslin expressed confidence. “Being on the front end is tumultuous,” he said, “but everyone is going to come along now. It’s going to be part of the transition.”
Starting on September 1, the busy and involved physician is going to take 13 days off. No Internet access. No computer. No office hours.
But Heslin won’t be leaving the world of achievement entirely behind him. He’s always wanted to climb Mount Kilimanjaro, the fourth highest free-standing mountain in the world at 19,334 feet above sea level, and that’s exactly what he said he’ll be doing.++