– “10% a year for maintenance fees and other “consultant” fees to keep his system running” should be “24% a year for purchase plus maintenance fee costs over 5 years…”, due to information that I just obtained from reading the article, “Finding a Cure: The Case for Regulation And Oversight of Electronic Health Records Systems”, Harvard Journal of Law & Technology 2008 vol. 22, No. 1, by Hoffman and Podgurski, discussed at http://blog.case.edu/case-news/2008/10/30/ehrregulation (and these authors are **for** regulation!)
– the phrase “(5 x $40000) + $44000 = $156000.00″ should have read “(5 x $40000) – $44000 = $156000.00″. Taking the above average purchase plus maintenance fee costs, I amend it now to read “(5 x $54000) – $44000 from stimulus bill = $226,000.00 to keep a more realistic conservative calculation of the true costs of certified electronic health records over 5 years.
– I would like to add to the last conclusionary paragraph a quote about the underpayment of doctors in the Medicare program, taken from a 3/6/2009 WSJ editorial on page A15. It should now read:

“What will really happen is that Medicare, which currently pays doctors 20% below what is paid by private insurance companies will begin to pay even less as it punishes them for not using c-EHR systems. This will force physicians to leave the program at a faster rate, creating a crisis when there won’t be enough physicians to care for the massive and still growing population of the elderly.”

Al

The reasons that 96% of physicians despise certified electronic health records (c-EHR) systems and thus are not purchasing c-EHR are that:

1) Across-the-board do not offer a ROI. c-EHR systems are expensive, increase overall costs, and destroy an office’s work flow.
2) c-EHR systems have not been shown to decrease errors, and on the contrary, have been shown to INCREASE them, introducing 22 new errors in one study.
3) Purchasing a CCHIT-certified EHR is associated with a 20-40% installation failure and with an 8% deinstallation rate thereafter.
4) CCHIT-certified EHR systems are not yet interoperable and in general do not allow data input like how physicians are used to- dictation, typing, inking.
5) c-EHR systems have not been demonstrated to increase quality in large, non-vendor associated prospective randomized studies.
6) Doctors generally consider most CCHIT features “bloat”.
7) Doctors hate e-prescribing and CPOE.

Let’s say that a physician who sees $100000.00/year worth of Medicare billings gets punished 5% for seeing Medicare patients without a c-EHR, and compare his situation over 5 years to a foolish physician who has capitulated to this atrocity. Let’s do the math:

– The non-complying physician will lose $5000 a year x 5 years for a total loss of $25000.00
– The foolish complying physician will lose 10% a year for maintenance fees and other “consultant” fees to keep his system running, AND he’ll lose another 15% to workflow losses and another 15% to the costs of entering in the data as well as reporting P4P for a total 40% loss per year, or (5 x $40000) + $44000 = $156000.00 total losses.

Note: The above figures are **conservative** and could be higher. Also, they don’t take into consideration the fact that the complying physician could be told that he didn’t use the c-EHR significantly thus voiding his earmark. It also doesn’t take into account losses associated with installation failures or deinstallations.

So the physicians without c-EHR systems will come out ahead after 5 years by a factor of 6!

What will really happen is that Medicare will end up failing faster than planned when physicians end up running for the exit door and either opt out completely or become nonparticipating providers. This will turn Medicare into an empty shell where there simply won’t be enough physicians to care for the massive and still growing population of the elderly.

Al

I went on CMS web site and found no such information pertaining to your above statement.

Please clearify as to where you have found this information..
Thank you,
Tim