A recent survey conducted by SK&A Information Services reports that “67% of medical offices with four or more physicians do not currently use [electronic medical record] software.” It is well-known that the healthcare industry lags behind other sectors in terms of information technology and automation. Paper medical records are grossly inefficient, and add billions to healthcare costs each year. Despite this fact, physicians are reluctant to adopt EMR software.

This is one of the main problems that led to the American Recovery and Reinvestment Act of 2009. The Stimulus Act sets aside $2 billion in discretionary health IT funding and $18 billion for incentive payments through Medicare and Medicaid. CMS will dole out between $44,000 and $64,000 per physician over five years for those who meet the program requirements. The point of the program is overcome physicians’ resistance to EMRs and promote their adoption.

Will the stimulus plan be enough overcome physicians’ reluctance? At this point it is hard to say. Many leading EMR suites cost tens of thousands, not counting hardware, networking, support, and maintenance. $44,000 may not pay for the more expensive CCHIT-certified systems. The stimulus package will increase demand for EMRs, which will cause their price to rise even more.

In addition to the high price tag, many physicians are simply “not computer people,” and prefer to keep using their paper charts. EMR systems also have a bad reputation. Everyone has heard the horror stories of failed implementations and $100,000 systems wasted because they are too complex, or do not function correctly. Rushing to install a system in order to cash in on stimulus payments will only make the implementation more difficult.

What then, is the answer? How can physicians reap the benefits of EMR and avoid the pitfalls? Simplicity is the key. Physicians should look for a simple system that meets their needs, avoids unnecessary complexity and expense, and can adapt to meet changing requirements. Simple systems are much easier to learn and implement, and are usually much less expensive than their counterparts.

The American Recovery and Reinvestment Act of 2009 includes provisions to encourage physicians to adopt Electronic Medical Records (EMRs). The act pays $44,000 to physicians that adopt EMRs over five years. On the other hand, the act will penalize non-adopters by decreasing their Medicare reimbursements.

Physicians must meet three criteria to qualify for the incentives. “Eligible professionals” must use a “certified EMR” in a “meaningful way.” In my last article we discussed those who may be considered eligible. This time we will look at the meaningful use requirement.

Physicians must demonstrate meaningful use of their EMR software to qualify for stimulus payments. Otherwise, they might be tempted to purchase an EMR just so they can get stimulus money, without any real intent to use the system. Much like the requirements for a “certified EMR,” the specific details comprising meaningful use have not yet been written. However, the Act does specify three general guidelines: E-prescribing, electronic exchange of medical records, and interoperability of systems.

E-prescribing is the electronic transmission of prescription information to a pharmacy. In many ways it is more efficient than paper or faxed prescriptions. Electronic prescriptions avoid the pitfalls of illegible handwriting or difficult-to-read faxes. In addition, e-prescribing may offer drug interaction checking, which will make sure prescribed drugs will not produce dangerous side affects when taken together. However, e-prescribing systems can be painfully slow, and require physicians to perform double-data entry. Many pharmacies may not yet be connected to the main e-prescribe network. There are many EMR-integrated and stand-alone E-prescribing systems, some of which are free.

Electronic exchange of medical records means an EMR system can send electronic notes, charts, lab results, or any other medical document. Sending photocopies of charts through the mail or fax is slow and unreliable. Electronic exchange is a more efficient way to share data. Security is the only downside to electronic data exchange. EMRs must conform to HIPAA regulations to protect patient privacy. If your EMR can export data to Microsoft Word or PDF files, then you can easily exchange data electronically.

Interoperability of systems takes electronic exchange of medical records one step further. Rather than just exchanging data, interoperable systems should be able to import data from other systems and export data to other systems in a seamless manner. This will guarantee information is saved in a standard format that can benefit everyone. Security and privacy is also a concern with interoperability. Any EMR that can import and export data in HL7 or XML should satisfy this requirement.

These high-level “meaningful use” requirements are fair and should be easily supported by most EMR systems. Although each requirement faces some challenges, physicians looking to purchase an EMR should not delay. Rather they should start early so they have plenty of time to begin using their new EMR in a meaningful way.