Incentives and Options Ease the Pain of EHR Adoption

By all accounts, the adoption of electronic health records has been agonizingly slow. According to a recent study published in the New England Journal of Medicine, only 9 percent of the nation’s hospitals have electronic health records. Whether these records are used to track quality of care and communicate with caregivers outside the hospital is another matter.

Now the Obama administration, through its economic recovery package, has included a health technology plan filled with incentives for adopting electronic health records—incentives that could put up to $65,000 in the hands of every physician and $3 million in hospital coffers if they demonstrate they are using health information technology in a significant manner.

“For a doctor running his or her own practice, these are sizable incentives that can make a very positive impact on their office’s bottom line,” says Chittaranjan Mallipeddi, CEO and founder of MedPlexus, a health IT services company. But, will physicians take advantage of the incentives?

Key obstacles

There are three barriers that have kept physicians from adopting electronic health records. These include affordability, support and maintenance, and the concern over training staff and the time it will take to be operational. Mallipeddi adds a fourth: Interoperability across practices. “If I buy a system from company A and someone has a system from company B, can they talk to each other?” he asks, rhetorically. “That’s a challenge.”

The challenge is greatest, Mallipeddi adds, for small and medium-sized practices that can ill afford to hire IT consultants to help with the installation and transition to an electronic health records environment. That smaller practice, if it were to adopt an electronic health record, would then store all patient data on the computer. What happens if the system crashes? “Then you’re toast,” Mallipeddi says. “You don’t know what medications your patients are taking because it’s all on the computer.”

MedPlexus offers an option called Software as a Service, or SaaS. Physician practices ‘lease’ their healthcare IT needs on a monthly subscription basis. SaaS helps practices keep up with software changes with virtually no effort. Since the software is hosted remotely, practices don’t need to invest in additional hardware to get started. MedPlexus hosts the applications and manages the maintenance, software upgrades and disaster recovery. “We provide the support to take away the pain and fear of adopting the technology,” Mallipeddi says. “If one server goes down, another takes over.”

Making sense

Jim Selenke, MD, with Total Health of Iowa, has been using the SaaS option for the past five years. Previously, the charts for the practice’s nearly 6,000 patients took an entire room to store. Now everything is stored on a server, making retrieval faster and easier. And the cost, Selenke says, has been extremely modest.

“For two physicians we pay $870 a month, and that includes all the software and all the support,” he explains. Previously, Selenke says the practice was being charged 16-cents a line in transcription costs. “That’s several thousand dollars a month just in transcription that we no longer have.” And cash flow improvements have been significant. “I’m on my own, so cash flow is king. All of my charges go out the next day [following a patient examination]. And all of our billing, all of our collections and all of our claims processes are done by one person. It saves a lot of money in labor costs, and it’s very efficient.”

Selenke says there are other incentives for adopting an electronic health record. He explains that Medicare currently reimburses 3 percent of charges to physicians who are e-prescribing and using an electronic health record. “In a few years, if you’re not doing it that way, they’re going to take 2 or 3 percent from you. So I think that should be enough incentive.” And if it isn’t, Selenke explains that since adopting the electronic health record, his medical malpractice carrier has reduced his premiums by 10 percent. “It’s just another reason for physicians to move in this direction.”

Getting on board

Selenke explains that the best route to successful adoption of an electronic health record is to get all physicians on board early. Let them know that whatever system the practice is adopting, it’s flexible. In other words, it’s not one size fits all. “I think that’s really important,” he says. “A lot of times an organization purchases a one-size-fits-all, and then nobody is happy.”

In addition, be honest. Let staff know that there will be some hurdles to clear, because adopting an electronic health record means a major change in the way the practice does business. “But the support staff will be there to help you, and that’s important. Because this is your livelihood; it’s your money, and you can’t play around with it and hope that things will get better.”

Ed Rabinowitz is a veteran healthcare writer and reporter. He welcomes comments at edwardr@frontiernet.net.