A-Rod:

For most physicians, I agree that buying a ready-made EMR is the best way to go. I like to tinker, from the days going back to my teenage years when I took apart cars (engine and all) to current modern-day setup of my office where I set up my network, put together many of my computers, and put together my EMR… I enjoy it and would not have it any other way. If I found that full particupation with Medicare was necessary, and/or that the eRx was worth it and/or that the HITECH “significant use” provisions were necessary, I would indeed eventually buy a c-EHR. Of course, you’d have to waterboard me and extract each and every one of my fingernails as well as kill my first born child to convince me to go with anything that HIMSS/CCHIT has tried to force onto the medical community, as I would find it tantamount to being manhandled by an illegal Mafia-like lobbying group.

If you actually do read my calculations in the link that I posted above, the $300000.00 5 year significant use figure was actually a low-ball amount for what “significant use” really implies (see the CMS website for a their evolving definition on this here- http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3466&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType ). The eRx, the reporting, the teaching involved will significantly retard my ability to see a significant caseload that would allow me to make a decent living. On top of that, Medicare payments have declined to a level where even without HITECH, I was about to jump ship in the next few years… HITECH simply has sped up my disenrollment process. Many physicians share these sentiments and I wrote an article on this here- “Congress Passed the Stimulus Bill; What Should You Do Now?”, http://www.hcplive.com/mdnglive/articles/PC_passed_the_stimulus . If enough physicians jump ship, the HITECH Act will be known as the “HITAIL OUT-OF-HERE” Act and the elderly will eventually pressure Congress to get rid of this ill-conceived law that is rife with way too much vendor political influence and politician corruption.

>>> $25,000 + minimum yearly maintenance would be much cheaper than your $175,000 expected costs.

The $300000.00 is divided into 3 parts:

1) Purchase costs, using average cost of $30000 with an average monthly cost of $1500/mo for the typical c-EHR of $125000.
2) “Significant Use” costs of $125000 (see article for particulars)
3) The need to have a $10000/year part-timer just to handle the reporting and extra “electronic paperwork”-> $50000/5 years.

Number 2 and 3 still apply to me if I were to go HITECH, thus the $175000. If I were to buy an eCW c-EHR, then I’d have to add in number 1 for a total 5 year cost of $300000.00.

So in summary, I consider a c-EHR a ripoff and the HITECH “significant use” law an ill-advised poorly thought out law that will fail miserably.

Cheers,
Al

To add insult to injury, if I purchase the five year service bundle of MagicJack, I’ll only pay $59.95. And I thought my Vonage Residential Premium Unlimited Plan at $24.99 per month was a good deal. Vonage actually cost $31.78 with all those nebulous Regulatory Recovery Surcharges, Emergency 911 Fees, and other hidden taxes.

Point to be made here, corporate HIT guys can learn much from the methods of us residential IT guys trying to keep down our cost.