The ARRA of 2009: What must physician practices do now in order to maximize stimulus incentives?

Included in the ARRA of 2009, is the Health Information Technology for Economic and
Clinical Health (HITECH) Act, which contains provisions to promote the adoption of electronic health records (EHRs) among physicians. Financial incentives will be made available to physicians through:

  • The establishment of grant programs which can be used for the purchase of certified EHR’s
  • The establishment of grants to States for low interest loans to help providers finance HIT’s
  • Medicare incentive payments designed to encourage physicians to adopt certified EHR’s
  • Penalties, through a reduction in Medicare payments for physicians who are not using certified EHR’s by a certain date
  • A 100% Federal match for the purchase of certified EHR’s by Medicaid providers

So, what should physicians be doing now to prepare for and obtain these financial incentives? In short, they should begin the construction of an EHR Strategy very soon, as the incentives can only be maximized for those who are demonstrating “meaningful use” (we’ll address the topic of meaningful use in another post) of an EHR in 2011. Key steps of a physician practice EHR Strategy would include:

Step 1 – Initiation of the Project

This may sound obvious, but good project management principles show that officially kicking this initiative off as a formal project is critical to its success. It is important that all stakeholders from the physician practice clearly understand the purpose of the plan and their individual role in its development. At this point, establish a project leader and project work team along with appropriate governance so that multiple levels of the practice can be consistently engaged throughout the process. Key stakeholders may include practice leaders, physicians, staff and even hospital leadership as appropriate.

Step 2 – Create a Current State Assessment

Conduct a current state assessment of the practices technological infrastructure to determine how well the Practice’s IT function is currently supporting and enabling the business, as well as Clinical practice. This assessment will identify areas of strong performance as well as opportunities for operational improvement or major vulnerabilities in IT management processes. At this point, a current state assessment of key processes and workflows is also recommended.

Step 3 – Define the Optimal Future State

Using the Practice’s current business plans and current IT capabilities as identified in the current state assessment, develop a strategic document that articulates the future state business priorities that will serve to guide the team during the strategic planning process. This will become the “vision” for the future.

Step 4 – Conduct a Gap Analysis

Perform an analysis of the Practice’s ability to realize business and Clinical value from IT investments. First, utilize the outputs of prior steps to determine the desired or future state. Then identify the major opportunities to improve business and IT alignment over the planning horizon. This phase identifies a set of changes needed in the Practice’s approach to managing IT and in technology overall.

Step 5 – Finalize and Communicate the Strategy

Develop the final deliverables and communicate the strategy to all stakeholders within the practice. Develop a communication document that will summarize the results from the prior phases (e.g., the strategic business context, the IT effectiveness assessment, the major opportunities, and the strategy). This deliverable is ideally suited to communicate the overall strategy to the entire practice. In addition, develop a more detailed strategy / implementation plan that will guide the practice through the first twelve (12) months of the strategy implementation. This plan will include a timeline for changes that the business requires, key IT enabled business initiatives, changes required in the approach to managing IT and key technology investments.

Most importantly, don’t delay. In order to maximize incentives, the Practice must be showing meaningful use by 2011. That would require planning efforts to begin as soon as possible.

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