After a long wait for clarification, hospitals received official notice from the IRS and CMS on how they could give away EMRs to doctors without facing kickback accusations. Very gradually, hospitals got into the act, trying out a wide variety of EMR subsidies and relationships with medical practice. Adoption still remains slow, but some hospitals are making headway.
Now, CMS has been given a big chunk of stimulus money to hand out for EMR incentives, enough that it may actually convince doctors to get on board. With that, hospitals suddenly have lost some leverage in what already was a tricky battle to further cement alliances with physicians.
Sure, in theory hospitals can still benefit from the rollout of EMRs whether the doctors work accept hospital donations or not. If the EMR platform is CCHIT-certified, it will hopefully be interoperable with any certified hospital system. (I say "hopefully" because there's always bugs to work out early in the lifespan of a complex product like an EMR, a fact that has, of course, been downplayed greatly by vendors,)
That being said, with each practice free to choose from a diverse list of systems, physicians could easily go from being potential partners to "clients" requiring significant IT support to participate fully in a hospital's clinical data initiatives. I don't hear CMS offering to subsidize those costs, do you?
For what it's worth, I'm not saying that the incentive programs are a bad thing for hospitals. There's certainly a lot of benefits hospitals can realize if their affiliated medical practices are EMR-friendly and capable of participating in larger data sharing initiatives. But the new incentives may mean that the hospitals' short window of opportunity for buying practices' love is over. - Anne