tech time

The Myth of Stimulus

Don't expect Uncle Sam to subsidize your practice's EHR system

SCOT MORRIS, O.D., F.A.A.O.

Through the past few months, I've heard a great many comments about the urgency to adopt electronic health records (EHR) to "get stimulus money." With each comment, I listen and try to expose the potential fallacies of this approach. I'm not sure where the original message got distorted, but let's look at the facts.

But first, let me just come out and say it: The stimulus money is something that most O.D.'s will never see. PERIOD. Even the largest healthcare institutions, such as Kaiser Permanente and Intermountain Healthcare, which are a decade ahead of most private-practice physicians in any specialty, have publicly acknowledged that they cannot meet the criteria set forth needed to demonstrate "meaningful use" — and thereby qualify for incentive payments.

The check's not in the mail

The factors that will inhibit optometrists from receiving stimulus dollars include:

► Timing and Definitions. There's no timely description of what "meaningful use" means to optometry. These criteria are not expected until sometime in 2013. Yet the major reimbursements for stimulus money start in 2011. See any issue here?
► EHR company adaptation. Once the government establishes criteria for optometry, most vendors will require time to adapt, test and roll out updated software. It's not their fault. They can't build something without blueprints. All the major vendors will adapt (in order to keep your business), but it may not be as soon as most practitioners would like.
► Reimbursement. Reimbursement is based on a percentage of Medicare utilization. Practices that see a low percentage of medical patients won't qualify for significant reimbursement. And most practices cannot add a significant number of medical patients in the next two to three years, if they have not already moved in that direction.

It's not about the stimulus

All that said, please move toward efficient utilization of EHR as well as other diagnostic and business management technologies. The stimulus money is not what should drive you toward EHR. Consider increased efficiency and productivity, improved patient safety, decreased overall business expenses and most important, the tremendous marketing and business management advantages that this technology utilization provides. In addition, $44,000 through five years is nothing. Let me repeat: It's nothing compared to the loss of efficiency, expenses incurred and the general lack of information that a traditional paper practice incurs. Inefficiency is the real enemy.

So, as you embark on adapting EHR and associated technologies, be cognizant of the process and implement at the appropriate speed for your office. Even with a proven plan, the conversion process typically takes three-to-six months. That includes workflow analysis, needs analysis, consultant selection for software/hardware/IT, training, integration, implementation and (finally) utilization. As I have said, technology is a tool that will help revolutionize your business. Technology isn't the business, only a tool to improve it. Take your time. Get the right help. Do it correctly. Be steady in your approach. OM