Guarantee Me

November 1, 2009
Pamela Moore, PhD

President Obama has promised as much as $44,000 to physicians using EHRs as part of the stimulus package he signed this year. Payments start in 2011. But there’s a catch.


President Obama has promised as much as $44,000 to physicians using EHRs as part of the stimulus package he signed this year. Payments start in 2011. But there’s a catch.

You have to be using a qualified electronic heath record and be using it in a meaningful way. Details on what “meaningful” and “qualified” mean should be out soon. The irony is that the stimulus bill may have had, for a time, the paradoxical effect of stifling technology purchases while uncertain physicians waited for clarity on some of the details. Everyone’s afraid they’ll buy an EHR, only to find out later that they bought the “wrong one” or that, for some other reason, they won’t get the money.

Meanwhile, EHR companies are trying to convince physicians to buy now. They’re offering guarantees, rebates, and plain old promises that their system will get you your money.

Practice Fusion, for example, guarantees that it will be a certified or qualified EHR, its users eligible for stimulus dollars. GE offers a warranty that its Centricity product will be certified, and also offers zero-interest financing to qualified buyers. NextGen guarantees that if it doesn’t meet the requirements for stimulus dollars, users will get their money back. Such deals have become de rigueur in the stimulus-fueled EHR world. These programs contractually oblige the vendors to meet the requirements. And it should lend some security to your purchasing choice. Get these promises in writing and check the fine print, of course, but remember that the vendors have every incentive to ensure that their products meet the federal guidelines.

But keep in mind that the actual EHR you buy is just the first step to opening Uncle Sam’s wallet. Vendors can say only that their software will meet the guidelines; whether it is used “meaningfully” really depends on you.

Just because a program can do something doesn’t mean that you’ll actually use it to do that. Buying a software product will not, by itself, improve your practice operations any more than buying a thesaurus will improve your vocabulary. You have to commit to revising work flows and actually using the software. Some products will seem more intuitive to use than others, given your sense of how things should work. That will be at least as important to your purchasing decision as whether the vendor guarantees to be qualified.

Also, to get the full $44,000 pay out, practices need to qualify annually for chunks of money; the cash begins flowing in 2011 and continues through 2015, and vendors will have to stay qualified for each of those years. Qualifying the first year will be relatively easy. Expect the requirements to get tougher and tougher every year and to focus even more on improving and reporting on clinical quality and interoperability - the ability of a provider to communicate easily with hospitals, other physicians, labs, and even patients. Ask vendors about their current strengths and future plans in these areas. Will you need additional products to really keep track of the needs of your patients? Does interoperability mean some patched together interface where multiple vendors have to agree to play together (fat chance)? Or something more seamless?

Sure, the clock is ticking. You should be shopping now and be implementing a system by mid-2010 to start getting your money in 2011, when the biggest incentive dollars roll down. But, as with any purchasing decision, you need to make the right choice, not just a fast one. (For help in selecting a system, search “EMR” at physicianspractice.com for multiple articles and other tools). Go wisely.

On a more personal note, this will be my final column for Physicians Practice. I’m not entirely leaving this beloved magazine; it’s my baby. I’m just also going to be helping out with some other magazines in our parent company and won’t have time to write. I’ve made many friends through this forum over the years, and I appreciate every e-mail you’ve sent and every nod or hoot of derision you’ve made as you’ve read my column. I hope we’ll stay friends. I know that this magazine, you, and I will remain true to the vision that physicians can have better practices, the way they want. I continue to applaud your every step along the way.

Pamela Moore is vice president, content and strategy, for CMPMedica, Physicians Practice’s parent corporation. Have parting thoughts? E-mail her at pam.moore@cmpmedica.com.

This article originally appeared in the November 2009 issue of Physicians Practice.