Tire kicking or due diligence?

A new post on the Advance magazine's HIT blog discusses whether the American Recovery and Reinvestment Act has spurred a flurry of EMR purchases, or whether the stimulus so far has only created a large number of "tire-kickers." That's a phrase I heard plenty from vendors at last month's Medical Group Management Association annual conference, and one that made a lot of sense, since the government incentives for health IT don't start until 2011.

Surveys suggest that hospitals already have their EMR plans in place, or at least well into the development phase, and since it can take a good 18 months or more to install an inpatient system, I imagine there aren't all that many hospitals just now jumping into the market. Besides, the incentive program really begins October 1, 2010, for hospitals, since Medicare Part A operates on the federal fiscal year. The MGMA crowd represents physician practices, which are on the Part B schedule and thus looking at a January 1, 2011, start date. That's where most of the shopping seems to be taking place.

But are they simply kicking the tires? The first comment on the Advance blog suggests otherwise: "What you are calling tire kicking I would call due-diligence." The commenter also points out that we still don't know what the final criteria for meaningful use of EMRs will look like. Sure, many vendors are offering guarantees now that their products will conform to whatever meaningful use turns out to be, but it's not so much what's in the software as much as it is what the customer does with it that will determine whether a doctor is using health IT in a meaningful way. So, yes, now would be a good time to make your plans and perform your due diligence on various EMR products.

I see a couple of analogies here. It's kind of like buying tax software before the end of the calendar year to get a jump on your tax returns. Congress inevitably makes some last-minute tweaks to the tax code as lawmakers finish up budget appropriations at the end of each year. Then it's up to the IRS to interpret the changes and publish its final rules. This often takes place early in the year, after the first versions of TurboTax and TaxCut have gone on sale. You'll need to download an update before the April 15 filing deadline.

Or it could be like window shopping right now for the inevitable Black Friday sales right after Thanksgiving so you know what product you want when there's a better buying opportunity. Some people make a habit of getting up early on Black Friday to get the doorbuster specials, while others would rather avoid the madness and shop when they're ready. Come to think of it, the latter strategy is exactly what most of the health IT consultants I talk to are recommending. And that could be why we aren't seeing too many EMR deals close just yet. - Neil