Economic stimulus package to offset costly EHR implementation

Lisa Eramo, CPC, for Medical Records Briefing, February 17, 2009

Healthcare providers looking for assistance with the adoption of EHRs may be in for a pleasant surprise, according to the Health Information Technology (HIT) Extension Program included in the American Recovery and Reinvestment Act of 2009 that President Barack Obama signed yesterday.

Title XIII of the Act focuses on HIT and quality, with $19 billion in grants and loans set aside for infrastructure and incentive payments under Medicare and Medicaid for providers who adopt certified EHR technology. The grants and loans include $17 billion slated for incentives, with $2 billion allotted to jump-start health IT adoption.

The Act also formalizes in statute the establishment within the Department of Health and Human Services an Office of the National Coordinator for HIT that was created during former President George W. Bush's administration. In addition, the Act establishes HIT policy and standards committees to promote a nationwide infrastructure.

Effectiveness of the incentives remain unknown
Will this be the much-needed fire to spark a widespread EHR adoption? Industry experts remain skeptical.

"I think it will help the industry move forward over the long haul, but do I think that we're going to see significant transformation over the next year or even two years? No I don't," says Chris Apgar, CISSP, president of Apgar & Associates, LLC in Portland, OR. "Yes, funds must be available, but ultimately, when it gets down to it, providers have to buy into it, and that's not going to be quick."

Others say the allotted funds may not be enough considering the colossal financial burden associated with an EHR implementation.

"Compared to the percentage of the GNP [gross national product] that healthcare is and the billions and billions of dollars that it costs to provide healthcare, it's sort of a drop in the bucket," says Darice Grzybowski, MA, RHIA, FAHIMA, president of HIMentors, LLC in LaGrange, IL. "However, any incentive for hospitals to adopt better electronic document management technologies is a step in the right direction. Motivation to get started is half the battle."

Interoperability remains yet another challenge in fostering a nationwide infrastructure, Apgar says. "Just because I incentivize someone to purchase and install an electronic health record doesn't mean that the electronic health record can talk to another electronic health record," he adds.

Smaller providers, clinics, and physician practices may benefit most from the financial assistance because of their tighter budgets, Apgar says. The information that these providers—particularly primary care physicians—gather is also important from a health data exchange standpoint, he adds. These physicians hold the much-needed patient demographic information, medical history information, and anecdotal data that will help improve overall patient care across a variety of settings.

Still others have a more hopeful outlook now that Congress has stepped up to the plate. AHIMA, for example, has been a long-time proponent of widespread EHR adoption.

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