Written by Stevie Davidson Thursday, 21 May 2009 16:54

I have found myself speaking quite a bit lately in forums, to clients and other venues on HITECH/ARRA.  It concerns me how confused healthcare professionals are with regards to how the physician reimbursement part of the ARRA is outlined and how it relates to them.

Even though "meaningful use" still needs to be defined, physicians are still under the impression that the reimbursement set from 2011-2015 will provide them with up front funding to purchase their EHR.  This is not the case.  It is important to realize that medical practices must make the initial up-front investment into their EHR solution.  They need to choose a product that is certified by a recognized body of certification, which is currently CCHIT. Reimbursement is per provider and not by practice, and physicians employed by hospitals are currently defined as not eligible.

Many physicians are hesitant on adopting EHR technology even with the ARRA dangling in front of them. Why? Well first, they still need to make a significant financial investment.  In addition, they are struggling with the understanding of what they really need to do in order to get a potential reimbursement for using their EHR in a meaningful way.  Many physicians are planning on retiring in the next 5-7 years?  Do they just take the penalties that are currently defined and wait it out?  

Part of what we do at HIC is try to educate as many healthcare professionals on what ARRA means, CCHIT and the importance of health management and reporting on clinical outcomes.  You would think by now CCHIT is practically a household name in the healthcare industry.  It is not.  Many people that I interact with every day are still unclear about what CCHIT really means and how it impacts their decision on a product.

Even though CCHIT is trying to develop new plans and criteria as fast as they can, it does not stop the boat. How does ARRA and CCHIT impact the physicians that already have a system in place and it is not certified? Think of all the time, resources and investments that has been made already.  Do they have to give up their current system to have a chance at obtaining reimbursement?  How many of them are participating in e-RX and PQRI already and are successfully receiving reimbursements with their current systems in place?

All of this is currently not defined, but I hope it will be soon.  I think this all adds to the skepticism and hesitation by many providers to adopt EHR into their practices.

For those who are still on paper, my best advice is to start looking now.  Do not wait until the last minute to say that you need to start looking at systems.  Finding experts that can help you through the process will be limited, and EHR vendors will begin to back-up on their implementations due to demand which will delay you into the 5 year reimbursement term.

Selection and implementation is a lengthy process to do it right.  You not only have to ensure you are choosing the right product and your contracts are negotiated well, but you need to give yourself time to plan plan plan and make sure that your system is built with the necessary data and workflows to enable you to document and report on it effectively.

Keep watching here for updates. Please do your homework when looking at systems.  Remember, just because a product is CCHIT certified, does not mean that from a usability perspective that is the right choice for you. Start now, but tread carefully.