Without new doc adoption, are EHR dollars truly 'incentives'?

The Medicare and Medicaid electronic health record incentive program is meant to propel widespread adoption of electronic medical record keeping, largely in an effort to improve patient care and reduce healthcare costs.

But a recent iWatch News analysis released by the Center for Program Integrity reveals that about half of the first group of incentive payments made to physicians attesting to Meaningful Use went to those who were using these systems before the incentive program was even created. Those results caused the center to express concern that the program won't work as intended because it's rewarding providers who already were on the EHR bandwagon, rather than converting providers to adopt the technology.   

There may be some validity to the concern: Several physician practices I've talked to who have received their incentive payments had been using EHR systems for years. For instance, Dr. Jeffrey Livingston, an OB/GYN in MacArthur, Texas, converted to EHRs in 2007; his group is using the $148,000 incentive payment it received in 2011 to grow the practice. AMS Cardiology in Abington, Pa., has been using an EHR system for four years and already was close to attesting for Meaningful Use prior to any legislation; the practice merely had to tweak one measurement category that hadn't been originally set up correctly, according to Dr. Andrew Fineman.

On another hand, it may just be that the early adopters are able to attest to Meaningful Use more quickly than providers who still are buying and adjusting to their EHR systems. One recent survey from Frost & Sullivan reports that hospitals' interest in EHR systems is significantly ramping up. And another survey from Sage Healthcare concludes that the adoption of EHRs continues to grow, and that Meaningful Use is still "the strongest driver to implement the technology."

There also seems to be a slow but steady change in attitude, especially as EHRs have become more affordable and word gets out that the technology reaps benefits, such as improved data reporting and increased efficiencies, according to Christine Kelly, president of CMK Consulting, in Baltimore. "Doctors don't like change," she says." But the payoff [to switch to EHRs] is great for them once they've made the transition," she points out.

That being said, practices need to set aside adequate time to research which system will work best for them, get trained in the use of the system, and use it effectively before being able to attest to Meaningful Use, Ocala, Fla. ophthalmologist Peter Polack tells FierceEMR. Polack's practice took two and a half years once it decided to purchase an EHR system before going live with the EHR in 2008, and another 18 months to phase the system in.

"If you haven't bought your system yet, you won't make Meaningful Use [in 2011] but you will have a year to implement it correctly without failure and loss of productivity," he notes. - Marla