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Check out this lower-cost way to an EHR


Hospitals can help you buy this software

Key Points

Is this the year you get electronic health records? It may be, now that more hospitals are taking advantage of a legal green light to help you buy this software.

The federal government carved out exceptions to anti-kickback and self-referral laws in 2006 to let hospitals subsidize up to 85 percent of the cost of EHR software for members of their medical staffs. Subsidies even cover training, Internet connectivity, and help-desk support. For a number of reasons, hospitals were slow at first to exploit these safe harbors, but the pace of EHR subsidies has picked up.

Before you accept this helping hand, ask yourself these questions. Otherwise, you may find your hospital EHR deal crashing like a bad hard drive.

How do I integrate a new EHR with my practice management system? You could easily pay an EHR vendor $5,000 or more for "interface" software that connects its program to your current practice management program, says healthcare IT consultant Mark Anderson in Montgomery, TX. This cost doesn't appear to qualify for federally blessed underwriting.

But don't despair. Subsidies can cover new practice management software provided it's coupled with the EHR program, and the software package is used "predominantly" for EHR purposes, according to the Feds. Some hospitals have already subsidized such combo deals, and that makes sense, since EHR and practice management systems are increasingly being sold as integrated products, often sharing the exact same database.

Will this software work in my office? While some hospitals may give you a choice of EHR programs, others may offer only one, and it may not be designed for your specialty, or a practice your size. Worse, it may be a clunky outpatient version of the hospital's inpatient software. "Two programs may have the same function, like e-prescribing, but one requires twice as many mouse clicks as the other," says healthcare IT consultant Barbara Drury in Larkspur, CO.

Who's accountable for what? In the ASP model, responsibilities such as software hosting, data backup, network maintenance, and software support can fall to the vendor, the hospital, or a designated third party. Boston healthcare attorney David Szabo says a doctor's contract with the hospital could require that if service isn't up to snuff-network downtime exceeds a specified threshold, for example-the hospital reduces what the doctor owes for his EHR (they're frequently charged on a monthly basis in ASP plans for the unsubsidized amount).

What happens if I want out? This is an important question, so consider it carefully. Your contract needs an exit clause so you can retain your EHR software and patient data if you leave town, for another opportunity, say, or no longer want the hospital or a digital surrogate to host your system.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
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© National Institute for Occupational Safety and Health