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HIMSS 2008: Carrot and Stick Approach

Gary Baldwin, for HealthLeaders Media, February 25, 2008
Partners Community Healthcare faced a common problem with its physician members. Beyond the members of Partners' academic medical center group practice, adoption of EMR technology was low. The AMC members used the Boston-based healthcare organization's own homegrown system, but primary care physicians lagged in technology adoption throughout the vast community setting Partners encompasses.

Yet, through a combination of carrots and sticks, Partners is on course for 100 percent EMR adoption by its 6,000 affiliated physicians by the end of 2009. Partners CIO Cynthia Bero told hundreds of participants at the HIMSS conference that although physicians understand the benefits of clinical automation, giving them an option about which software to use was a major boost to the effort.

To facilitate physician participation, Partners negotiated pay-for-performance incentives from three managed care plans. The payers agreed to pool money from one year to the next, in the event a practice took longer than anticipated to implement. Partners also provided a "total cost of ownership" analysis to its community physicians. The fiscal analysis was tailored to individual practices. By demonstrating the long-term ROI of an IT investment, the organization helped allay physician fears, Bero observed. Leaning on local and regional physician leaders also helped.

In 2007, Partners added a stick to the various payer carrots it had dangled. It mandated EMR use by any new physician group joining its network, and later expanded the mandate to include all physicians. But physician acceptance has played out better than expected. Only 16 physicians out of some 1,100 primary care physicians opted to leave the network.

Bero's presentation was part of the 2008 HIMSS conference, which is taking place in Orlando this week.

--Gary Baldwin