One of my biggest fears about the carrot and stick approach to the HITECH EHR stimulus package is that many doctors are never going to see any of the EHR stimulus package. Not because they aren’t going to implement an EHR, but because they won’t meet the “meaningful use” criteria that HITECH requires.

This isn’t a view that I share alone. Take a look at the following two comments made about HITECH’s inability to actually pay the doctors who participate.

CEOMike’s (CEO of Medscribbler) take on doctor’s qualifying for the EHR stimulus:

Not only is the EMR have to qualify – THE DOCTOR IS GOING TO HAVE TO QUALIFY – the experience with e-prescribing and the incentives programs is a LOT of doctors who thought they would get money didn’t even though their EMR produced the required information – a lot of times the information produced by the EMR proved the doctor did NOT qualify !!!

Remember this is government !!!

Al Borg’s take on past projects similar to the HITECH reimbursement plan:

In past demonstration projects, less than half of physicians or practices ever got any money and those that did got much less than what they thought they would get (the most recent one the 40% which were winners won only $600 on average). Everyone that participated ended up a loser, whether they got paid or not. Are they nuts?

Certainly some people will see the money. The question is whether you’ll be one of them. It’s why I still believe that $18 billion of EHR Stimulus won’t actually be spent.

I love how people are saying that $18 billion will be spent on EHR adoption due to what has been dubbed the HITECH act. My question is how did they come up with the $18 billion number? I guess you could say that it’s the max that the government has permitted to be spent. However, if that’s the case, then shouldn’t people be saying that $18 billion MIGHT be spent to stimulate EHR adoption?

Seriously, what if doctors don’t like any of the certified EHR (whatever that turns out to be) and decide not to implement an EHR? What if Medicaid and Medicare make “meaningful EMR use” so difficult to achieve that most doctors who implement an EHR don’t actual see the stimulus from the government?

I’m not trying to say that the government isn’t going to pay our billions of dollars to those who have implemented an EHR. I have a feeling that billions will be paid out as medicare and medicaid bonuses. However, I don’t know how they got the number of $18 billion. For all we know, it could end up being $2 billion.

Plus, we have to ask ourselves the purpose of the HITECH act. Many have said that it’s to “stimulate EHR adoption.” I have a strong feeling that those existing EHR users will be the ones who benefit most. If $15 billion of the $18 billion allocated goes to existing EHR users, then that doesn’t sound like a good investment used to increase EHR adoption to me.