The question of timing to get HITECH Act reimbursement is on everyone's mind for obvious reasons. On the one hand, the federal government is saying to hurry up to get the maximum reimbursement by Jan. 1, 2011. At the same time the government is also saying to wait until at least the end of the year before the regulations come to clarify what a "qualified EHR" or a "meaningful user" means. That has left many physician practices on the fence about when to make a move.
Dr. Jim Morrow, a family physician at North Fulton Family Practice in Atlanta, cut through the dilemma with some good old Southern straight talk at a crowded session on the stimulus money.
"If you want the money, pick you a vendor while you are here," Morrow says. "If you are going to be a meaningful user in 2011, the time to act is now."
Attorney Edward Shy says that with the regulations coming late in the year, "2010 will be a horse race" as vendors respond to RFPs to have physician practices up and running by 2011.
The fear among some in the industry is that even with the stimulus incentive, some physicians may still be reluctant to fully jump into EHR. Morrow, who says his practice saved more than $30 per patient visit when it digitized a decade ago, hopes his colleagues finally see the light.
"Now is the time for docs to quit crying and whining about electronic records. Now is the time to take advantage of this money because it is the most you'll ever see."
Health IT and healthcare reform
Congress is never short on creating complexity, but may just now be realizing how intricate any meaningful healthcare reform will be, especially under a deadline of July 31 to be done by the August recess. U.S. Rep Phil Gingrey (R-Georgia) points out that no fewer than three committees—Energy and Commerce, Ways and Means, and Education and Labor—will have to work concurrently.
"It's an awfully short period of time to get things done," Gingrey says. "How in the world can you get all that done and done right? We can't afford to make a mistake with 18% of our economy."
Gingrey said that if he had his choice, he would concentrate just on the IT equation. Former Wyoming Gov. Jim Gehringer, however, asked whether "we can have health IT without health reform?"
"Technology is a means to an end. Health reform is an overhaul. If we automate a bad system all we will get is a really fast bad system."
Gehringer says he expects the states to take up the cause of health reform in a way that has been unforeseen. Unlike past years, states like Minnesota and Indiana are taking up healthcare reform without politics playing a heavy role. The federal government's role will be to provide standards and leadership, he says.
Gingrey, an obstetrician by profession, says he hopes to push for incentives for doctors to spend time with patients on end-of-life care and advance directives, believing that even 45 minutes of honest conversation could provide care the patient wants and eventually save unnecessary care for Medicare.