As I mentioned in my last post, I’m going to take some time over the next week or so to look ahead to 2012 and discuss what I think is going to happen in the world of EMR and health IT. Since today is the regularly scheduled Meaningful Use Monday, I decided that it would be appropriate to take a look forward at Meaningful Use in 2012.
In many ways, 2012 is not going to see any major public shifts in meaningful use. Sure, we’re going to learn more about meaningful use stage 2, we’re also going to finally get out of the temporary EHR certification to the permanent EHR certification (unless something crazy happens). Although, I don’t think either of those things are going to make much real difference in the lives of doctors. Instead, there’s going to be an undercurrent of other trends that shape the future of EHR incentives and meaningful use.
Here we go:
Doctors First Hand Experiences – As Dr. Koriwchak notes in his physician perspective on meaningful use, there aren’t that many first hand experiences out there from physicians discussing their experience with meaningful use. Most of what you find out there are physicians that have been asked by their EHR vendor to be the face of that EHR vendor’s meaningful use efforts.
In 2012, whether published publicly or heard through the grapevine, doctors first hand experience with EMR implementations, EHR incentive and meaningful use are going to start filtering through the medical community. I bet Dr. Koriwchak isn’t going to be alone in his assessment that basically, I survived meaningful use, but recommend staying away. If this is the message about meaningful use that spreads, then expect more people like Dr. West opting out of Medicare or just accepting the possible EHR penalties.
Meaningful Use Audits – We know that audits of those who took EHR incentive money are coming. I think that CMS (I think they have authority over this, right?) will be generous with their audits. They won’t make it easy and fun for the person who gets audited and fails. However, I don’t think they’re going to try and make a public disgrace of those that have their meaningful use attestation audited. Doing so would set back the entire program. Instead I think CMS will try and spread the message that they’re serious about honest meaningful use attestation, but that they’ll be reasonable in their approach.
Checks Flowing Ok, so it won’t really be checks since most of the payments are going to be wired into doctors bank accounts, but you get the idea. Either way, there’s going to be a lot of doctors that are finally going to get paid for their EHR effort in 2012. This will no doubt invoke some portion of envy in their physician peers. I know I’d hate having my doctor friend getting a check and me not getting it. I felt this same way when people were buying houses and getting the government money for buying a house a couple years ago. Doctors won’t be immune to this sort of “jealousy” of their peers.
The real question is whether the money flowing will be a stronger force on EHR adoption or whether the above mentioned meaningful use pains will be stronger. As you see in my next two predictions, I think it is a split verdict.
Hospitals Capitalize – My best prediction is that hospitals will see the money flowing and be unable to resist following the money line. We’ve already largely seen this shift in hospitals IT projects. I know a number of healthcare entrepreneurs who have said that hospitals aren’t really doing any major IT projects outside of meaningful use. Hospitals will continue this trend and will likely end up taking the majority of the EHR stimulus money that’s being paid out.
Small Doctors Offices Stay Away – As I wrote about previously, most EHR incentive money is being paid to existing EHR users. In 2012 we’ll be moving past those existing EHR users and I predict that most small doctors offices will continue to sit on the sideline of EHR. The money isn’t large enough for small doctors to overcome all the work required for them to implement an EHR and the EHR penalties are a drop in the bucket for most of these doctors.
I imagine that many will be thinking, “What about the other EHR benefits beyond EHR stimulus money?” To that I’d say, you’re absolutely right. There are plenty of other benefits to having an EHR that don’t include government money for EHR. Unfortunately, the free government money has created this myopic view of the world where those other benefits have lost all their appeal.
Ok, you’re turn. Any other things you see happening with meaningful use in 2012? Any of my meaningful use predictions that you disagree with?