If you're in a small practice the $44K from the feds may be more Trojan horse than gift

To many physicians, meaningful-use qualification looks like more of the same: a maze of bureaucracy, attestation forms and applications, and new outlays for software, hardware and consulting services, with a very uncertain chance of receiving a check from Medicare or Medicaid when all is said and done. David Kibbe MD in Family Practice Management

I'm bothered by the fact that too many practices are making their information technology choices based on an elusive and ill defined set of goals coming down from on high.  How likely is it that policy makers in D.C. are going to nail the perfect definition of meaningful use?  I know these are really smart folks and respect their pedigrees, but I've also seen the inordinate focus on minutia and tangential issues coupled with monstrous reporting burden in other 'quality improvement' initiatives (just think back to PQRI).

The $40K gift horse of ARRA is very appealing to any struggling primary care doc, but I worry that this may be more of a Trojan horse filled with unfunded reporting and trivial pursuit mandates.

My suggestion to colleagues:  don't wait on folks from D.C. to get it right - the chances are slim.  "CCHIT certified" and other labels are almost meaningless.  Let common sense guide your IT adoption.  If the product enables better care for your patients then it's worth checking out.  If the only thing the system will do is allow you to better bill for services then think again. 

For the folks in D.C.: many docs in the front lines are holding back on EMR because they can still work faster and do more with their paper systems or minimal IT investment. Until the products are actually better than what they have, there's little incentive to switch.

A one-time 'windfall' of $44K is nothing compared to endlessly frustrating EMR that slows down the day to day operations of a practice.  The reluctance in the field is due to smart docs recognizing a bum deal when they see one. 

The promise of population health improvement through the better use of information technology is not served with a one time purchase subsidy - it is served by changing the payment paradigm to support population health management.

If CMS shifted an additional 5% of the Medicare budged to primary care it would fully fund the work of exemplary primary care.  Of all health care spending, increased spending in primary care is the only segment that improves overall results and reduces overall costs.

Comments

[family practice emr]

You know it depends on the system that you chose. If you're in a small practice, you can minimize your work through free EMR systems. Well, if you have the budget and it doesn't affect the budget of other cares, then why not? Actually, paper works are still there but fewer.
-nj