There are hardship exceptions available for critical access hospitals in the regulations, vendors are offering flexible payment solutions where providers can pay for systems on the backend, and there are grants for regional extension centers and states to help providers implement EHR systems and achieve "meaningful use" and establish health information exchanges. But time keeps ticking, deadlines are looming, and there is still an enormous amount of work to be done. It seems to me that many of the providers who need the incentive payments the most are probably facing penalties instead.
There will be thousands of hospitals and physicians trying to do the right thing very quickly, says Overhage. "The risk is significant that we won't do it right."
With the likelihood that many rural and small community providers will lag behind, will that threaten to drag the whole effort under or can the early adopters and larger systems achieve enough success to keep the momentum towards a national electronic health system moving forward?
I don't have the answers. And the early adopters of EHRs have concerns of their own. Many do not know whether their existing systems will be certified or if they will have to make major upgrades to their existing systems or even start from scratch.
The demand on vendors from existing clients could be enormous not to mention all the new clients that will want to implement systems—and fast. I know vendors are promising they will have the resources to meet the demand and their systems will be certified. I guess time will tell whether they were right.