>>> there are less expensive and less burdensome options for physicians that are critical in the value equation I outlined previously.

The average cost of a c-EHR nowadays is $33000.00 plus $1500.00/month maintenance. Sure, there are cheaper ones, but overall if they are CCHIT certified, their cost will generally be no less than half those figures, which is still very expensive. SOMEONE has to pay for the HIMSS “CCHIT” tax!

The most important issue here, though, is not just cost, but also the fact that Medicare is trying to impose more clerical work on physicians that will ultimately slow them down, decreasing from their overall patient contact time, and thus ultimately affecting their incomes. If, say, a physician who sees $100,000.00 in Medicare patients, with average visit time being 20 minutes, and is paid an average of $100 per visit, has to take an extra 5 minutes to do pay for performance reporting and documentation, in just 5 years this will cost him $125,000.00. Ahhh… I guess it all does come down to cost, doesn’t it?

Do the math:

$100000.00/$100 = 1000 visits x 5 min = 5000 minutes for P4P/20 min per visit = 250 visits robbed by P4P x $100/visit = $25,000.00 per year x 5 years = $125,000.00 over 5 years

Amazing, huh? For most docs, it’s just obvious. For me, this will go into my next MDNG column (“The HIT Realist”) later on this month.

Cheers,
Al

An EMR installation does not have to be multi-thousand. With an SaaS EMR solution, a physician can be up and running pretty quickly with a minimal amt of overhead, no IT staff to speak of and since it is a monthly fee, easily expensed.

The big problem in this industry is the dated view that you need to have the EMR on-site. This client-server architecture/approach, while find for a large practice is simply too burdensome for smaller ones.

Thus, getting back to my original comment, which you failed to quote in yours, there are less expensive and less burdensome options for physicians that are critical in the value equation I outlined previously.

You really think that simply cutting physician payments, then returning said money as an “incentive” to buy a multi-thousand dollar EHR installation fraught with all the HIT issues will entice the majority of physicians not currently on-board to buy into HIT?

Wrong… Won’t work. Look, CCHIT-EHRs had the backing of the HHS Leavitt and President Bush and the initiative still can be regarded as a failure since it did NOT increase adoption rates by any means. What will happen with incentives is that Medicare and third party payers will see their physician panels decline and on a long-term basis less good applicants will choose to go to medical school. Overall quality of medicine will die out.

I’m speaking from personal experience. I’m not saying everyone else is incompetent; instead, I’m saying that I’ve been hesitant to publish information for fear that I’d be ridiculed.

Or lets try this from a different angle–think of the report on UTMB* from a couple of years back (which was fascinating). Imagine a parallel universe where their embarrassing report has not been leaked to the public. In this parallel universe, if they take action on one of those items, and it saves them millions of dollars, will they want to submit that as a “cheap and easy way to save money?”

“Hey everyone. We did an internal audit, and discovered that we were paying millions in consulting fees, to consultants with no real project or goal! We cancelled their contract, which took no time at all, and with this quick and easy step, made lots of room in our budget! I should have done this years ago! Signed, proud CIO.”

* I don’t mean to pick on UTMB, but their audit was dynamite.