While CMS is actively encouraging the use of EHRs through the meaningful use incentive program, it may be sending a mixed message courtesy of a recent transmittal. Effective Dec. 10, the transmittal discourages providers from using what are known as limited space templates to collect patient information. The electronic templates can include checklists and predetermined answers, and are designed to speed up patient documentation. However, they don't include space for detailed clinical information. CMS said information created by the templates would not be considered sufficient documentation of a face-to-face visit by Medicare program integrity contractors conducting pre or post-payment claims reviews.

James L. Oakes, Jr., a principal with Health Care Information Consultants, LLC in Baltimore, told me that the CMS transmittal may lead to some reductions in EHR use by providers, but would mostly lead to provider dissatisfaction. Oakes said the bigger issues is that some providers are getting more worried about the government looking over their shoulder and making it more difficult to practice medicine.