Positive vs Negative Reinforcement to Promote Use of EHR

Secretary of Health and Human Services Kathleen Sebelius says in Kaiser Health News:

Today, in almost every other sector besides health, electronic information exchange is the way we do business. A cashier scans a bar code to add up our grocery bill. We check our bank balance and take out cash with a debit card that works in any ATM machine.

But despite the clear benefits of health IT, only two in ten doctors and one in ten hospitals use even a basic electronic record system.

The most promising sign for the future of our health care system is not what stakeholders were saying, but what they’re already doing.

• Major insurers like Aetna, United and WellPoint announced their own provider loan and training programs for electronic health records.
• The Federation of State Medical Boards announced that is taking the first steps toward encouraging the use of health IT to maintain professional licensing.
• And two of the nation’s largest provider groups, Delaware’s Christiana Care Health System and Partners HealthCare in Massachusetts, said that in the future they’re going train and support providers who adopt electronic health records, and avoid providers who don't make the switch to health IT.

http://www.kaiserhealthnews.org/Columns/2010/August/082610Sebelius.aspx

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We've all been hearing about positive reinforcement like bonus payments for meaningful use of an EHR. Negative reinforcement in the form of being dropped by insurers, avoided by provider groups -- and losing one's license! -- would be more effective.