For the last few months, many “experts” have warned that providers should hold off on investing in new technology because there was a lack of specificity in two main areas – certification of “approved” products, and the definition of “meaningful use.” (In the language of the federal legislation, physicians who implement an “approved” EHR/EMR system and employ it in a “meaningful use” fashion may be eligible for a rebate of up to $44,000 per provider.)
As an example of the so-called experts’ opinions, recently I had a meeting with a very senior healthcare policy appointee and advisor to a state governor who emphatically stated that, “any provider who invests in technology right now, before these details are set, is crazy.” She said she was telling that same story to anyone who would listen, including healthcare providers, associations, etc.
This is truly wrong-headed thinking, and here’s why:
- The selection and implementation of technology should be based on a business case and ROI analysis, not on expected rebates from a third party. If a physician practice or clinic cannot cost-justify the benefits of implementing new technology or automation based on improved patient care, lowered staff and training costs, etc., then they shouldn’t implement it at all, they should stick with the pencil-and-paper method. (However, any casual observer would ask the question, why does UPS, FedEx, McDonalds and Domino’s Pizza think technology saves them money and improves service, when their margins are lower and they have high turnover of low-educated staff? Wouldn’t healthcare, with higher margins, lower turnover and more trained staff, be an even greater candidate for the benefits of technology and automation?)
- Software vendors have limited training and implementation staffs. It takes many months to select and implement EMR/EHR systems. If you wait, you will very likely not be able to show “meaningful use” in time to take advantage of any of the stimulus reimbursements. In fact the clock is already ticking (see reason #4 below). This is going to by like Y2K, where there aren’t enough technical resources to go around, and this is a real problem, not an imaginary one.
- Even though the final details of the certifications haven’t been finalized, most experts agree that CCHIT (The Certification Commission for Health Information and Technology) will be the governing body, and there are many leading products and vendors that are already CCHIT-certified. In addition, “meaningful use” includes e-prescribing, the ability to exchange information and the capability to report quality data.
- The clock is ticking. The $44,000 rebate per provider is paid out over 5 years, but it is front-end loaded. The largest amount, with $18,000 being rebated in 2011 or 2012 for the previous year. That means to get the $18,000 rebate for 2011, you would have to have the system up and running for all of 2010. That’s barely 6 months away…
- This isn’t merely about the loss of potential rebates. Starting in 2015, there will be actual penalties (in the form of decreased reimbursements of up to 5%) for not adopting EMR/EHR systems. That means if your net margins are currently 10%, your profits will be cut in half.
The bottom line? The stimulus package should not dissuade you from making investments in your future. Be responsible, consider your business and clinical needs, and select a software package that is already CCHIT certified and get going on implementation with a professional IT firm. If you wait, you will almost certainly regret it.
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