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The pain of change

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   By Ken Anderberg, Publisher/Editorial Director, February 2010

Ken Anderberg

Changing an organization's processes usually is a difficult task. People are used to the way "things have always been done" and often are reluctant to try something new — such as accepting technology solutions they are unfamiliar with. It's called "human nature" and a not-unexpected response when the subject of electronic medical records (EMR) is broached.

Staunch objections to EMRs generally have centered on either lost productivity or costs, mostly the latter. The HITECH Act addresses the cost issue by providing billions of dollars for electronic records implementations, but getting $44,000 back from the feds for a system that might cost a physician's office $150,000 does not necessarily create strong demand to move from paper to electronic records. Now, however, a number of EMR vendors and several large hospital systems are lending a hand.

Vendors are offering delayed financing, or loans, that do not have to be repaid until fed money starts flowing next year. Some hospitals are basically matching the federal stimulus money for their physicians. Regulations allow hospitals to subsidize the cost of their physicians' EMR systems — but those physicians must pay 15 percent of the cost under Medicare rules.

A new report from healthcare market-research publisher Kalorama Information contends that vendors and hospitals need to step up, as they are doing, in order to bring momentum to this technological shift.

"A body at rest stays at rest unless acted upon by an outside force," says Bruce Carlson, publisher of Kalorama Information. "Hospitals and large health systems will need to have parallel incentives in order for the EMR concept to happen in a meaningful way.

"The announcement of government incentives of up to $18,000 in increased Medicare payments to doctors for the meaningful use of EMR has created interest," Carlson says. "But these incentives represent future payouts for EMR systems that physicians have to pay for today, at a time when patients are paying bills slower, expenses are up and some physicians are laying off staff."

He cites North Shore-Long Island Jewish Health System in New York as an example of a hospital system offering subsidies to its affiliated physicians who implement EMR systems — in this case up to $40,000 over five years. Tufts Medical Center and Beth Israel Deaconess in Boston also have their own EMR incentive programs.

"Vendor actions also are piggybacking off government incentives, enhancing their effect," he adds. Offering "stimulus guarantees," he says, where the customer is assured the system will earn stimulus incentives from CMS, has garnered interest. Athenahealth, ChartLogic, e-MDs and GE Healthcare are among vendors who have adopted some form of this strategy.

Looks like there is a lot of financial incentive out there to take the leap. Are you ready?

Ken Anderbergkanderberg@healthmgttech.com


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