The Stimulus offers genuine incentives for physicians, but getting your practice EHR-ready means an upfront investment of time and money.

Marianne Matthews

Of all medical professionals, radiologists are among the first to embrace the world of digital technology. So it would seem that the radiology community would be tickled by President Obama’s new stimulus package.

The American Recovery and Reinvestment Act of 2009 includes approximately $19 billion in grants and incentives for health information technology, primarily for the adoption of electronic health records. The incentives will begin to flow in 2011. In short, physicians who qualify as “meaningful users” of electronic health records (EHR) will be eligible to receive additional payments under Medicare that can extend over 5 years.

For early adopters (those who qualify in 2011 or 2012) the first year incentive could be as high as $18,000. From there, the ceiling declines each year, with a $12,000 maximum incentive for the second year; $8,000 in the third year; $4,000 in the fourth year; $2,000 in the fifth; and zero for subsequent years.

But in order to collect your incentive payments, you must be a “meaningful user” of “certified” EHR. And here is where the questions begin to arise.

In a recent podcast interview with Pat Wise, RN, MS, MA, FHIMSS, vice president, healthcare information systems, HIMSS, I asked for a definition of “meaningful use.” According to Wise, “Meaningful use includes the ability to capture patient demographics and clinical health information such as medical history and problem lists. And the ability to provide clinical decision support for physician order entry; capture and query information relevant to health care quality; and exchange electronic health information—and integrate that information —with other sources.”

Are radiologists who currently use EHR using them in this “meaningful” way? Many in the industry, including the American College of Radiology, say that “meaningful use” will need to be further defined through the rule-making process. While nothing in the language of the act necessarily suggests it, there may well be various definitions of “meaningful use” depending on physician specialty.

Then there is the issue of “certified” EHR. The selection of a certification body is still under way. While many in the health care industry anticipate the official certification body will be the Certification Commission for Healthcare Information Technology, there is no guarantee.

What if your existing EHR doesn’t ultimately qualify as “certified”? And how about radiology practices that have yet to implement a system? The fact is, EHRs are costly.

A 2005 study by the Medical Group Management Association Center for Research and the University of Minnesota School of Public Health looked at EHR adoption by US medical group practices. The study found that the average purchase and implementation cost of an EHR was $32,606 per full-time-equivalent physician. Maintenance costs were an additional $1,500 per physician per month.

Getting your practice EHR-ready is no small task. Even in the radiology community, which sees itself as a step ahead technologically, there will be a need for financial investing, due diligence with vendor selection, education, and training. There will be dollars that must be spent, learning curves to overcome, and time frames to meet.

Stimulus. Webster’s defines it as “something that rouses or incites to action or increased action.” The stimulus bill holds great promise—genuine incentives for physicians and improved care for patients. Still, for private practitioners, the stimulus is likely to feel like a pinch before the tickle kicks in.

Marianne Matthews