Comments on: President Obama signed the American Recovery and Reinvestment Act of 2009 today, which includes funding for Health Information Technology.

By: Evan Steele, CEO SRSsoft

Evan Steele, CEO SRSsoft — Fri, 20 Feb 2009 18:06:35 +0000

In response to Pam Hennigan’s comment, the $44,000 is an incentive for use of a certified EMR; it is not reimbursement for the costs of purchasing an EMR nor upgrading an existing EMR. To qualify for the incentive payments, you will first need to make sure that your EMR meets the government’s criteria, and then on an annual basis, physicians must demonstrate “meaningful use” of the EMR. What they will have to do to prove this is yet to be determined.

As for who can receive incentive payments, Section 4101(a)(0)(6)(C) of the legislation limits “eligible providers” to physicians.

By: Pam Hennigan

Pam Hennigan — Fri, 20 Feb 2009 04:42:14 +0000

If we have been on a CCHIT certified EHR for 10 years. Now want to add modules such as e-prescribing, electronic encounter forms, order entry, etc. Will we still be eligible for the full $44,000 for each physician (does physician also denote Non-Physician Providers as well)to allow us to upgrade our software and hardware, some of which is sorely out of date? Would any balance up to the $44,000 maximum be available to reimburse for some of our previous expense in implementing and training our existing EHR?

By: Evan Steele, CEO SRSsoft

Evan Steele, CEO SRSsoft — Thu, 19 Feb 2009 01:35:09 +0000

In response to James Hart’s question, we are using the term “government EMR” to describe the EHR systems that the government will define as the systems you must “meaningfully use” if you want to be considered for incentive payments. No one knows exactly what the “government EMR” will look like, because as you pointed out, the initial set of criteria are yet to be defined by a committee, which is yet to be appointed by the National Coordinator, David Kolodner.

There are several issues of concern regarding the criteria and how they are to be established:
• The HIT policy committee will be made up of well over 20 people, only one of whom must be a practicing physician. It is therefore unlikely that their decisions will be in the best interest of busy medical practitioners.
• The Secretary of HHS has been given a deadline of Dec. 31, 2009 to accept an initial set of standards. Given the short timeframe, not to mention the absence of a Secretary at the current time, it is likely that the government will simply adopt and possibly strengthen existing CCHIT standards. These are the standards underlying many existing EMRs, and those EMRs do not have a track record of success.
• The criteria are going to become more stringent over time, first because of the point above, and second because the legislation charges the Secretary with making them so. Therefore, what is defined as a “government EMR” for the early years of the program will not meet the criteria in the latter years without substantial modification. In a webcast today, the CEO of HIMSS advised physicians who want to try for the incentive payments to build guarantees into their contracts with vendors for just this reason.

To your last point, what’s good for our company is what’s good for physicians. The success of SRS has been based on providing solutions that physicians find usable and helpful in their efforts to provide the best patient care in the most efficient manner.

By: James Hart

James Hart — Wed, 18 Feb 2009 18:53:49 +0000

What exactly is a “government EMR” ?

Have they developed there own program already? I thought the ONC is setting up standards for current or future EHRs to follow?

I believe this Act will be in your company favor as long as you comply to whatever set of standards they come up with.

By: Evan Steele, CEO SRSsoft

Evan Steele, CEO SRSsoft — Wed, 18 Feb 2009 16:42:31 +0000

To Ron Mitchell,
Thank you for sharing your thoughts. The goals of the incentive program are indeed admirable, however they will not be met by requiring the type of EMRs that physicians have traditionally found to be unusable. The SRS hybrid EMR enables physicians to increase the quality of care they provide, but in a manner designed to increase their productivity, allowing them to provide this enhanced care to a greater number of patients. The only “trend” that SRS is fighting is the trend toward adoption of EMR systems that are unusable and negatively impact physician productivity. Of what value is an EMR that has all of the government’s desired features if it is deemed unusable by physicians?

The hybrid EMR does what the government wants, but not in a way that costs the physicians time and money. Included in “meaningful EHR user” are the following:

1) ePrescribing: SRS has an easy to use ePrescribing module, which far surpasses the capabilities, usability and design of ePrescribing in what will likely be the “government” EMRs. SRS reduces prescribing errors, allows physicians to check for drug-to-drug and drug-to-allergy interactions, and facilitates the sharing of Rx data with other providers.

2) Exchange of information: Information is not “locked-up” in our hybrid EMR. The hybrid EMR has the ability to share data; our clients have done so with local RHIOs.

3) Reporting: SRS has an extremely robust data and reporting capability. In contrast to “government EMRs,” it is structured on the premise that the measures that are important to report should be determined up-front, and then data entry can be limited to those data, rather than requiring physicians to spend time entering all possible data through a cumbersome, time-consuming process (which experience has shown, tends to be abandoned quickly because of its onerous nature). SRS users who have chosen to do so have been able to provide all data required to take advantage of PQRI and other P4P programs.

If future government definitions of “EMR” allow physicians to be productive to the point where the productivity gains outweigh the costs (financial and operational) of adopting and using the systems, then SRS will tailor its hybrid EMR to meet the government’s standards.