Today I was looking through my Twitter inbox and found this complaint, by @lee_ritz:
EMR systems are putting private physician groups out of business–we can’t afford to compete with the big hospital groups.
Certainly, it’s hard to argue that some EMRs can put a big strain ( as much as $50K+ per doctor) on medical practices . And for those in low-margin specialties like primary care, perhaps that could be the death-blow financially. But are we at a point where we need to somehow pay for EMRs for small practices above and beyond Meaningful Use incentives?
One way to address this problem comes straight from the loving arms of the American Hospital Association.
Right now, the HHS Office of the Inspector General has proposed a rule which would extend the EMR safe harbor — allowing hospitals to donate EMRs and health IT to practices and not face a kickback investigation — from the end of this year until December 31, 2106. Looked at one way, that’s a pretty good offer, as it and gives both hospitals and medical practices the change to get those donated EMRs in place and situated while both sides iron out Meaningful Use issues.
The AHA is arguing that safe harbor protections should be made permanent. Its executives argue that the safe harbor is a valuable tool for getting health IT into the hands of rural physicians; that with the donations, hospitals can provide the tech support, training and maintenance medical practices need to use EMRs properly; and that hospitals can donate EMRs to physicians across entire areas, ensuring interoperability.
The AHA also notes that not all providers are eligible for Meaningful Use incentives, and that new physicians, presumably needing hospital help to get their EMRs rolling, will begin to practice after the deadline has passed. And on top of all of this, the AHA letter to the OIG states, changes in interoperable technologies will require new donations going forward if doctors and hospitals are to stay connected.
Is this the solution to the problem of making sure cash-strapped smaller practices can afford to have powerful EMR technologies that connect with hospitals and peers? It’s hard to say, but I do think there’s some merit to at least extending the protections further and keeping a close eye on what happens.
In this day and age, when getting EMRs into medical practices is such a key federal objective, it does seem to me that the hospitals deserve a generous turn at bat. After all, the money has to some from somewhere.