There have been a number of articles and studies that have come out recently that suggest that hospitals are unlikely to receive the EMR stimulus money from the HITECH Act. Here’s one study from CSC that’s been summarized by Ken Terry from BNet. Then, there’s also this Mckinsey analysis that was talked about by Paul Roemer on Healthcare IT Strategy. In this study it talks about the costs of implementing an EMR being more than the stimulus money.
Of course, I like to take studies with a grain of salt. I think you can generally manipulate the numbers any way you want them to appear. However, these findings should wake healthcare up to the idea that all is not rosy when it comes to free government handouts.
However, one thing that I think they did miss in the above articles was the fact that in meaningful use stage 1 it’s basically all based upon self attestation of results. That’s right. I assume you’ll have some login to a portal where you’ll attest that you indeed have implemented and followed all of the meaningful use stage one guidelines. Seriously, you just tell them that you’ve done it and they give you the money.
So, where’s the challenge?
First, self attestation is for meaningful use stage 1. We don’t know how they’ll handle meaningful use reporting for stage 2 and 3. It could be the same or it could be more rigorous. We’ll have to see.
Second, I imagine ONC/HHS/CMS will implement some sort of audit plan for self attestation. However, considering their budget and past government history, I bet this audit plan won’t be as much about finding those who lied and cheated the system. It will be more about measuring how many people lied and cheated the system. It’s a numbers game where the government has to live with a certain amount of dishonesty while still achieving their objectives. That said, I wouldn’t want to be the clinic that is caught in a lie about their meaningful use of an EHR.
I’m still personally not on or off the EMR stimulus bandwagon. I still personally believe it’s best to use it as a bonus plan and not part of your core EMR implementation strategy.
Very interesting article, can’t imagine how hard it will be to audit every doctor and hospital to make sure they followed the correct guidelines to receive the stimulus money.
We’re seeing both sides: pessimistic providers who do not think anyone will successfully meet the criteria, and those that think they are already meeting it. The EMR vendors are driven to make this happen – as they have promised MU compliance to all their customers, it’s largely on them to make it work.
The self-attestation is ONLY acceptable for the EP’s initial year of participation in Phase 1 of MU. In the 2nd year, they must submit 90 consecutive days of encounter reporting which demonstrates that they have attained the %’s of compliance required by the statute. In 3rd and subsequent years, the 90 days of reporting becomes an entire year of consecutive data. This is my understanding…
Great comments.
Andrew, yep, that’s the point I think. They just won’t. It would be impossible.
EMR Software, I agree that EMR vendors will be given the burden of doctors showing meaningful use whether they like it or not. They have no obligation to really do it other than ‘customer service.’
Wes, I’m interested to see how the phase 2 and 3 of MU make the reporting happen. Imagine a years worth of clinical data flowing from the doctor to CMS. They wouldn’t know what to do with all that data.