Investing Capital in EMR
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"It's very expensive for everyone to be using an EMR, but it's the right thing to do," says Susan Doliner, Maine Medical Center's vice president for development. "The EMR is the most significant advancement we have ever made. This will change the way care is delivered. … It will make a huge difference in efficiency, confidentiality, and safety."
The leadership team at Maine Medical Center will track patient satisfaction surveys and will look for less duplication of testing, fewer medical errors, improved patient safety, more efficiency, and process workflow improvement to determine if the EMR is a success. "All of these areas will be measured for continuous improvement," Doliner says.
Doliner notes that Maine Medical Center is making a considerable capital investment in the EMR to improve the care it delivers while simultaneously dealing with a shifting reimbursement model that will result in less revenue. "It's like having one foot in two canoes," she says. "We are all going to be reimbursed less for what we are doing. … As you look to the future, to the way hospitals will be reimbursed, it will depend on how healthy their community is."
"In moving toward accountable care and population health management, the reimbursement system still has not evolved to reimburse well for these kinds of activities," Heye echoes. "Until we craft a better way to get hospitals reimbursed for preventable care and avoiding hospital admissions, it's going to make things more difficult."
According to Heye, Maine Medical Center's decision to implement the EMR was not motivated by CMS' meaningful use incentives, which can amount to millions of dollars for eligible hospitals that use EMR technology to reach certain CMS-defined benchmarks to improve the quality of patient care.
"At Maine Medical Center, we didn't budget for meaningful use in funding the EMR project. It's better to go ahead and do this for the right reasons, and if we happen to get some money back from the federal government, then that will be quite fortuitous," says Heye, who acknowledges that the medical center expects to receive "a substantial amount of MU dollars."
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