Stimulating IT Spending

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 - Mary C. Tierney
Mary C. Tierney

As you know, investment and enrichment in EMRs is the focus of the American Recovery and Reinvestment Act of 2009—which allocates a whopping $19.2 billion to health IT. The numbers have been well-publicized, with $17.2 billion being funneled through the Medicare and Medicaid programs to help providers adopt EHRs and another $2 billion earmarked for the Office of the National Coordinator for Health Information Technology (ONC). Outside the direct contributions to pay for IT systems, there is another $10.4 million in related spending, according to HIMSS, for telecommunications, broadband and telemedicine. 

This is likely the biggest thing ever to happen to health IT, addressing the top two barriers to implementation: acquisition and ongoing costs.

As you’ll see in detail in this month’s cover story, office-based physicians can earn $44,000 in Medicare bonus payments over a five-year period if they demonstrate “meaningful use” of EHRs starting in 2011. For hospitals, starting in fiscal year 2011, there is a baseline annual incentive of $2 million, with an extra $200 paid per discharge for the 1,150th through 23,000th discharge each year.

Now it’s time to watch closely as ONC solidifies the standards and policies (committee development is underway) to allow EHRs to communicate via interoperability. Cost and quality can’t change if data are isolated in silos. Standards are due late this year—which doesn’t give facilities much lead-time before the 2011 mandates. Privacy is another concern. Who owns the data—and who gets to look at it, a JAMA article recently asked. Over time, we hope this huge investment will improve billing and internal cost control, and especially provide better decision-making tools to clinicians and patients alike to improve health with better outcomes. We also hope it will save jobs, save money, reduce errors and transform healthcare as promised. As patients, we hope it doesn’t mean less medicine and less therapy—denials—for people who need it.

But in the Great Recession, how can a facility survive and thrive? Be smart, spend wisely, cut back on non-essentials, effectively leverage resources and let technology help increase efficiency. Our cover story also shares some examples of how seven facilities and healthcare systems are marketing on a (tight) budget, solving mammography staffing challenges, distributing radiologist workloads and sub-specialist consults, improving charge documentation and getting paid faster, and utilizing a single worklist uniting the workload of multiple PACS.