For those of you who don't know, the American Recovery and Reinvestment Act (ARRA) of 2009 has a section in itspecifically targeted towards health information technology - called HITECH. In it, there are dollars set aside for providers who take Medicare and Medicaid patients to encourage them to adopt electronic medical records (EMR) systems. There are also penalties for not adopting the technology by a certain deadline. A practice that begins its adoption by no later than 2012 can earn up to a maximum of $44,000, though the practice will have to bear the up-front cost and apply for repayment. I've included a picture of the payment schedule from my reading of the act.
While $44,000 might sound like a lot of money for a piece of software, it's not the software that was the cost driver for this practice. Of course the manager mentioned how the EMR changes a practice's workflow; an EMR is not a bolt-on technology that helps solve one particular problem more effectively, such as a new bed management system that optimizes the utilization of the beds in a facility. So the time spent by the practice to change how they do business is a cost, but not one that's easily quantified.
The cost that surprised me, and one I'd taken for granted, was pointed out when the manager talked about the conversion of paper charts to the EMR. A brand-new practice that started on Day 1 with an EMR wouldn't incur this cost, but one that had been in business for decades would have an enormous burden to bear in inputting a patient's history into the EMR.
So when this tangible and necessary cost is taken into account, the $44,000 is a contribution, but is certainly not sufficient in covering the cost of EMR adoption by physician practices. Any practice that is considering pursuing the dollars promosed by HITECH for EMR adoption will need to broaden their perspective of what the total cost of an EMR truly is.
