Doctors to Feds: Take Your Electronic-Record Subsidies and Shove 'Em

Physicians still aren't breaking down the doors to buy electronic health records, despite government financial incentives of $44,000-$64,000 per doctor that begin in 2011.

I learned this from electronic health record (EHR) vendors I spoke with at the just-concluded annual convention of HIMSS, the leading health IT professional society. "The tsunami hasn't arrived yet," said Ken Ernsting, vice president of business development for Sage Software, at the Atlanta meeting. Heather Caouette, director of communications for eClinicalWorks, said that while business has been good, few physicians who have recently purchased her company's EHR said it has been because of the government subsidies.

An Accenture study released at HIMSS shows that the majority of doctors who don't yet have EHRs plan to acquire them. In the survey of physicians in practices of 10 or fewer doctors, 58 percent said they planned to buy an EHR within the next two years, and about half of those counted on getting financial help from their hospitals. But it's one thing to say you want to do something, and it's another to do it.

One factor holding back physicians is that to get Uncle Sam's money, they have to show "meaningful use" of a qualified EHR, and no one yet knows exactly what that means. While the Department of Health and Human Services has published proposed meaningful use and EHR certification criteria, the final rules won't be published until sometime in the spring -- and perhaps not until the very last day of spring, said HHS official David Hunt at the HIMSS conference. That could leave doctors scratching their heads until it's too late for them to gear up and snag the maximum subsidies.

At least the government has finally pulled its head out of the sand and announced rules for certifying EHR certification bodies (you read that right). At present, the only such entity is the private, non-profit Certification Commission for Health IT (CCHIT), which has been putting its stamp of approval on EHRs for the past four years.

Considering the short timeline that Congress gave HHS to launch its big EHR program, it would have made sense to name CCHIT the interim certification body for HHS. But because of a dispute over the major software vendors' alleged influence on CCHIT, that didn't happen. Instead, HHS has finally coughed up requirements for "temporary" and "permanent" certification organizations so that the process can move forward. Guess who will probably do all of the temporary certification?

Meanwhile, the prospect of physicians jumping on the EHR bandwagon has companies across the HIT spectrum salivating. Epocrates, heretofore known for its prescribing knowledge base designed for mobile devices, is launching an EHR. So is MedPlus, a subsidiary of reference lab giant Quest Diagnostics. 4medica, which mainly serves as a conduit between hospital-owned practices and hospital and reference labs, has combined its lab ordering and resulting service with electronic prescribing and an online tool to view hospital reports into what it calls an integrated health record. All of these companies, of course, claim that customers will be able to meet the meaningful use criteria.

What's good about these efforts, as well as the various products offered by connectivity firms, is that they're challenging the paradigm of the traditional EHR. As the meaningful use criteria move the industry in the direction of more health information exchange across the spectrum of care, this type of innovation will accelerate. And, to the extent that that leads to physicians having more of the information they need to make good medical decisions, it's going to improve the quality and efficiency of health care.

Image supplied courtesy of Dan O'Day Talks About Radio.