The American Recovery and Reinvestment Act makes it clear that providers will have to demonstrate "meaningful use" of certified EMRs to earn Medicare bonuses of up to $44,000 or extra Medicaid payments that could reach $63,750. Not just any product will do.
As we cover in the Also Noted section of this newsletter today, the Certification Commission for Healthcare Information Technology is updating its testing protocols to reflect the interim final rule on EMR data standards, a key component of meaningful use. Monday in FierceHealthIT, we reported that Booz Allen Hamilton had won a federal contract to develop a process for certifying EMRs, further opening the door to competition in the certification arena. Earlier this month, we mentioned a survey from KLAS Enterprises showing that physicians in ambulatory practice had serious doubts about whether systems from SRSsoft and Amazing Charts--neither of which is certified--would get them to meaningful use.
But does any of this matter to SRSsoft CEO Evan Steele? Not really. The Montvale, N.J.-based company primarily targets "high-performance" specialties like cardiology, orthopedics and ophthalmology that generate much higher billing rates than primary care, and Steele has no intention of seeking certification so his customers can earn the bonuses. "There's no ROI for them to participate in this [EMR subsidy] program right now," Steele tells FierceEMR. "The cost of buying and the loss of efficiency dwarfs what the government is offering."
The problem, according to Steele, is that meaningful use, as recently proposed, calls for the capture of discrete data elements and that certification largely is based on traditional EMR systems, which Steele believes force doctors to become clerks. In the shipping business, delivery personnel or the customers themselves enter much of the data. Fast-food chains track inventory with information entered by low-wage employees on the front line. "In healthcare, they're asking the big wage earners to do the data entry," Steele says.
Large, integrated organizations with employed physicians--think Kaiser Permanente, Geisinger Health or the Indian Health Service--can afford to have their doctors enter data, Steele says, but private practices need to focus more on efficiency. "Any business that runs efficiently takes better care of their customers," Steele says. This, he believes, translates into better care and, under current reimbursement policies, higher income. Going for meaningful use and the related extra payments could slow them down.
"Our clients, they fully expect not to get the money," says Steele.