The EHR incentives in the American Recovery and Reinvestment Act (ARRA) will cause nearly every healthcare organization to tear up their IT strategy and plans. The incentives are significant and the time lines are incredibly aggressive for most organizations. We cannot simply overlay the new work on top of the existing plans.
Healthcare, like corporate America, is focused on belt-tightening. I have a backlog of really good ideas to reduce the cost of care to our patients. Our new focus on Electronic Health Records will reduce our ability to implement these ideas.
This is a game changer. Time to rethink what you can get done and when you can do it. Even the time to develop a new strategy is limited. If we spend the rest of 2009 planning and waiting for the definition of meaningful use we have a year to implement an EHR in our medical group and a year to implement the hospital EHR. Talk about all hands on deck.
Then again, I think that was the purpose of the legislation. Get healthcare organizations to make EHRs a top priority to get them implemented once-and-for-all.
Is your organization looking at the ARRA this way?
Candid CIO 
Technology changes are only 20% of the effort. Cultural, workflow and resource training are the other 80% and there are no off the shelf or turnkey EHR implementations to ease implementation and assist with this effort in the unreasonable period required. Therefore, my experience tells me organizational inertia will prevent successful implementation in most organizations. In addition, is it reasonable to expect success in this nation wide effort where these changes have to occur at each health care implementer, using resource strapped health care vendors with outmoded product designs and technology in a 2-year period? I would like to have access to the authors’ of this bill’s source of serotonin.
While it is prudent to move briskly toward “meaningful use”, the statute does not really penalize anyone for a little foot dragging. After all, as long as you are “meaningfully using” by 2013, you don’t really lose hospital money.
On the physician side, Medicare gives you until 2012, Medicaid until 2011 before you have any reductions. Of course, rolling out one clinic per year is probably an issue … but panic flight into EMR is probably not necessary.
As for meaningful use, don’t you expect that the requirements will be generally reasonable within the guidelines of Certification, ePrescribing, HIT Connectivity, and Quality reporting?
Yes we are ripping everything up to implement the EHR. We’re changing our focus so everything is on the EHR. We were focusing on an opensource EHR but the ARRA funds force us to use a CCHIT certified one.
Sounds like a great strategy. Take your thoughtful strategically planned initiatives and throw them out the window chasing some possible government cash. Or were the plans not very thoughtful or strategic?
Certainly, there’s a fair amount of cash on the line that should be considered. However, anyone that “tears up their IT strategy” means that they did a poor job making an IT strategy. Reevaluate it maybe, but not tear it up.
Sometimes the world changes in radically and unpredicted ways. Your strategies are always based on the current environment and a set of assumptions. When those assumptions prove wrong, you need to come up with a new plan.
Finally – the potetnial cash paymnets for a fully implemented EHR suddenly make the ROI of such endeavors undeniably lucrative for CFO support. Clinicians have always been behind it, but due to lack of solid (real cahs generation) ROI, EHR initiatives have been very hard to fund appropriately A direct link to $ that come as a direct result of the investment is all we ever needed to bump such projects to the very top of the priority/funding list.
Now, all we need is the economy to turn around a bit so the CFO relaxes a bit about spending our precious cash reserves.
It is always great to hear from an old friend.
always been behind it, but due to lack of solid (real cahs generation) ROI, EHR initiatives have been very hard to fund appropriately A direct link to $ that come as a direct result of the investment is all we ever needed to bump such projects to the very top of the priority/funding list.
Sometimes the world changes in radically and unpredicted ways. Your strategies are always based on the current environment and a set of assumptions. When those assumptions prove wrong, you need to come up with a new plan.