The HITECH Act, a component of the American Recovery and Reinvestment Act of 2009, aims to subsidize EMR adoption by allocating up to $40K per physician, broken into yearly payments. Most of the money comes in the first two years; $15K, and $12K respectively. In order to claim this money, physicians must be a qualified professional using a certified system in a meaningful way. However, there are a few factors that will likely cause the HITECH act to fail. Physicians dragging their feet on EMR purchases, the limited installation capacity of CCHIT-certified vendors, and the difficulty of implementing CCHIT-certified systems will make it very difficult for physicians to qualify in time to receive payouts for the first two years.

Despite the hype about the HITECH Act, many physicians are still dragging their feet. According to experts, physicians take 6 months, on average, to decide on an EMR package. This is normal for any expensive purchase. However, the HITECH Act has made things worse. No one wants to buy an EMR until the definition of “certified system” has been settled. The committee is scheduled to publish the standards by January, 2010. This delay makes it more difficult for physicians to qualify for the first year payout.

While the “certified system” specifications have not been written at this time, many assume “certified” will mean “CCHIT Certified.” CCHIT is an independent body that certifies EMR systems. Because CCHIT systems are so complicated and time-consuming to install, many vendors have installation backlogs of up to six months. To make matters worse, only about 8% of all EMR vendors are CCHIT-certified for 2009. The backlog will increase as 2011 approaches and physicians feel the pressure to purchase. EMR Vendors have a finite ability to install systems. Even if they hire more technicians to install EMRs, it will still take time to train them and get the implementations going. As a result, it is unlikely they will be able to ramp up their production to meet demand.

CCHIT-certified systems are often complex and difficult to implement. Most of these systems require servers, and physicians may also need new computers, printers, networking gear, and other hardware. All of this has to be ordered and set up before the system can be installed. The CCHIT standard contains hundreds of criteria that makes systems unwieldy. As a result, training can be time consuming and frustrating. Experts estimate that it can take anywhere from six months to a year to start using a new EMR system in a “meaningful way.”

Physicians dragging their feet, vendor backlogs, and implementation difficulty make it unlikely that the majority of physicians will qualify in time to receive the first two payouts. Is the HITECH Act Doomed? Not necessarily. The public has started to recognize the problem with CCHIT-certified systems, and there is a good chance the committee will opt for more appropriate criteria. To guarantee your participation in the program, get started as soon as possible by selecting a simple and efficient EMR that’s quick to install, easy to learn, and easy to change. If you follow these criteria and get started soon, you should have no problem.

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Ryan Ricks

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