EHR purchase not nearly enough to reach Meaningful Use

Hospitals and physicians have been driving fairly hard on electronic health record (EHR) adoption over the past year or two, partly in response to the financial incentives for Meaningful Use of EHRs under the American Recovery and Reinvestment Act. Those incentives kick in next year and physicians who qualify in 2011 and 2012 will be in a position to collect the entire incentive payment. However, those who don’t quality until 2013 or 2014 will get less. For physicians starting in 2011 or 2012 means the potential to collect $44,000 compared with only $24,000 for those who don’t qualify until 2014. The hospital rules are a little more complicated; still the earlier they qualify the better they do.

Two new reports show that physicians and hospitals are struggling to reach Meaningful Use. That’s not necessarily a bad thing, because it means the Meaningful Use bar was set high enough so that we taxpayers are likely to see some significant improvements for our investment. But I am concerned that some providers will start to give up on EHR adoption once it looks like the incentives are out of reach. On the other hand, the drafters of the legislation thought about this, too, and implemented a penalty phase that kicks in after 2015.

Human nature being what it is, I expect we’ll see a slowdown in EHR adoption in 2012 and 2013 as the incentives appear out of reach, followed by a pickup as we get closer to 2015 and penalties loom. The picture for hospitals may look a little different as they will likely continue trying to make incremental progress. Still I think the big push will come for the laggards once they start getting slapped.

According to the first report (Survey: Top 5 reasons providers not ready for meaningful use) only about 10 percent of EHR buyers are on track for Meaningful Use adoption. Their top 5 reasons for lagging sound about right to me:

  1. A lack of substantive support from their EHR vendor (93 percent);
  2. Delayed implementation due to the cost of additional support from EHR vendor/consultants (89 percent);
  3. A hurried selection of an EHR vendor has resulted in negative consequences (82 percent);
  4. Lack available and/or trained staff to properly implement an EHR (77 percent); and
  5. They are unprepared and underfunded to rectify difficult system interfaces (69 percent).

In the other report (‘Meaningful use’ readiness drops among hospital CIOs) hospitals indicated the going gets tougher the closer they get to the meaningful use qualification deadline.

“One potential reason for the drop in confidence may be due to the fact that CIOs are getting a clear view of the horizon, as many of their questions are being answered by federal agencies,” Chuck Christian, director of information systems and CIO at Good Samaritan Hospital in Vincennes, Ind., says in a CHIME press release. “Many of the clarifications are adding to the complexity of the task at hand.”

December 13, 2010

One thought on “EHR purchase not nearly enough to reach Meaningful Use”

  1. Yes… as long as the rulemakers continue to pile requirements on the already confusing and complex requirements the perception of the Medical Community will be that this was another cruel attempt to have physicians take time from the caring for patients and put thier full attention on a bureacratic morass. The incentives already do not pay for the effort or the reduction in revenue that will happen because of the “changes” that are necessary to meet the basic requirements. I think people are starting to feel that there was never any intention to pay the incentives.

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