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Are They Nuts?
In the article below, they just don't get it. This "federal I.T. incentive plan" calls for physicians to not only buy expensive, massive c-EHR systems, but also forces them to throw away their old EMR technology, to use the new technology in a "meaningful way" as demanded by big government, and then only if the doctor does everything just right will he may get some money, up to $42000 over 5 years for a system that can cost as much as $250000 a license. We have to bow down to work flow killing mandates such as e-prescribing and reporting on individual patient care parameters that will further erode our profit margins. Are they nuts?
In past demonstration projects, less than half of physicians or practices ever got any money and those that did got much less than what they thought they would get (the most recent one the 40% which were winners won only $600 on average). Everyone that participated ended up a loser, whether they got paid or not. Are they nuts?
Here we have a set of mandates promulgated by the CEO of Allscripts who is the one in power as President Obama's personal HIT adviser after he donated $144300.00 in a quid pro quo manner to President Obama... and they want us to pay attention and follow his lead? Are they nuts?
They want us to use c-EHR systems to allow big government to data mine our electronic charts to eventually cut our payments- are they nuts?
Doctors need time to see their patients and to see many of them in order to survive. Anything that slows them down for stupid reporting schemes like what is called by these mandates will be ignored and eventually place Medicare at risk when doctors begin to disenroll from the program.
Bottom line: doctors hate c-EHR systems and what they represent. That is why in a poll at sermo, over 90% of physicians are planning to opt out of this bill full of HIT mandates. Many plan on opting out of Medicare altogether. Medicare will eventually end up with less providers to see the anticipated patient surge that will come on in the next 10 years.
Congress, Mr. Obama, you are going to kill Medicare. Are you listening???
I for one will be publishing my next story in my "HIT Realist" column at MDNG magazine next month on what to do if you plan on not buying a c-EHR system. The title will be: "Congress Passes Stimulus Bill; What Should You Do Now?" (Hint: there are 9 no-c-EHR paths that you can take successfully to make real money- more than double what the maximum promised by Congress!)
I wish other reporters would touch on these sentiments. Here is another article that missed the reality of the situation why docs are so depressed, although the recession angle is important- Does Stimulus Misread Physician Economics?HDM editor Gary Baldwin, 2/23/2009The federal I.T. incentive plan may appear to be an enormous carrot, dangling potentially tens of thousands of dollars before physician practices that adopt clinical I.T.Yet, given the woeful state of the economy, after-the-fact adoption incentives alone may not be enough to motivate physician practices to join the digital fold, observes Tim Zoph, vice president and CIO at Northwestern Memorial Hospital, Chicago."Given the state of the economy, with a drop off in patient volume, many physicians feel their practices are at risk," he notes. "As we talk about payment incentives, it is a difficult notion for practices to think about the amount of investment and change they must make when the economy is not doing well."While Zoph praises the overall intent of the incentive plan, he emphasizes that unless physician practices get help both funding and implementing electronic record technology, they will hard pressed to change their documentation habits."Physicians need support on the front end," he says. "They do not have access to capital or to the know-how of people who can help them implement. This is a major change at a time when practices are fragile economically."For its part, Northwestern is analyzing how it can use the relaxed Stark rules to help physician groups get over the economic hurdle of buying a system. "It is difficult for practices to think about taking on additional risk," the CIO says.URL: http://www.healthdatamanagement.com/news/stimulus27776-1.html?ET=healthdatamanagement:e777:555a:&st=email&channel=policies_regulation
Al Borges, M.D.
Al:
The Stark Rules are rapidly becoming a hornet's nest of liability for doctors and hospitals - I still haven't met one person who can explain them in five minutes using non-legalese jargon. Modifying them furter for HIT implementations will only benefit the health care consultants who - last time I checked - don't actually take care of patients.
I have other predictions:
- The Stimulus Give Away Package will soon drop off the radar screens of doctors everywhere due to massive cuts in Medicare reimbursements (in the name of "fiscal responsibility".)
- The President is going to put his cost-cutting hat on and slash Medicare reimbursements as he expands the number of people in the plan.
- Look for privately-run Medicare Advantage plans to disappear soon.
- Look for Medicare to function more like Medicaid and the VA system.
- Look for doctors to pitch a huge fit and drop Medicare/Medicaid plans in record numbers.
- I predict an increase is private, pay-for-service plans with no insurance middlemen. It will be like the schools in the US - many people paying for the public schools but refusing to use them and instead, paying for private schools (like President and Mrs. Obama).
- Also, look for the media to portray doctors as greedy, selfish, and corrupt. I predict we'll get the "CEO treatment" real soon.
Dagmar,
Nice post.
Obama cannot cut the deficit without cutting spending. By that time docs believe the check is in the mail for putting in their expensive EMR, Obama will announce his deficit-cutting steps. The public's not going to cry over docs not getting their $41,000 for putting in an certified EMR......if it didn't make sense for a doc to pay for it, then why should it make sense for the government to foot the bill, they'll say. Additionally, by that time the evidence will be in: docs who installed the expensive software showed no improvement in what matters to the public- the more than $15,000 yearly cost for medical care for a family of four!