MGMA In Practice blog

Guest blog by Lucien Roberts, MHA, FACMPE, MGMA member, executive director, Neuropsychological Services of Virginia, Richmond, Va.

After a long wait, "meaningful use" has been defined, and the electronic health record (EHR) certification guidelines are within days of publication. Now is the time for many medical practices to finally make the migration to EHR.

I have a confession, though. I'm not ready for ARRAgeddon.  My practice doesn't have an EHR, and thinking about moving forward with one gives me chills. Sure, there's the $44,000 per physician incentive in stimulus money, and I know the longer I wait the more that number will shrink. But I also know that EHRs can cost a lot more than $44,000 per physician in upfront expenditures, training, implementation, downtime and ongoing maintenance.

My inbox has been deluged with e-mails offering guarantees of stimulus dollars from vendors. Every healthcare organization out there is offering me a Webinar on the "meaningful use" guidelines. Some are free, others are not. Even my 77-year-old mother, who learned about "meaningful use" during a recent visit to her doctor, may offer her own Webinar. At least Mom's will offer a great recipe or two.

While "meaningful use" and EHR certification are critical, they don't keep me up at night. I want to understand "meaningful use," after all, it's the benchmark for capturing stimulus incentives. I also want to understand the certification guidelines but decided months ago the only EHRs we'd evaluate in our practice must be CCHIT-certified. Vendor promises of future CCHIT will not cut it.

Contracting, training and implementation are my primary concerns.

These three areas are where I can save a lot of money for my practice, or make EHR a big, ugly money pit. And these concerns seem to be but footnotes in most of the offerings out there.   

One exception, I hope, is MGMA's three-part Webinar series that starts Jan. 26. I've signed up for it because it's the only Webinar series that addresses what I feel are the key issues of EHR migration. And by doing the series, I get a CD of different tools to help with the migration and a copy of speaker Margret Amatayakul's book, Electronic Health Records: Transforming Your Medical Practice, 2nd edition, that I almost bought at the MGMA 2009 Annual Conference. 

• The first Webinar in the series is an overview: What's "meaningful use" and certification, and what are the hoops we must jump through to qualify for stimulus dollars? One highlight: There will be discussion on preparing practices for migration to EHRs.
• The second Webinar will address EHR evaluation and selection. More importantly, it promises to address two of my three big concerns: contracting and training. I'm thinking this Webinar is where I will more than recoup my investment in the series. The speakers have helped lots of practices select and purchase EHRs, and I want to glean their contracting/negotiation tips. I want to know how best to use my training dollars and how to prepare my staff and doctors so these dollars are not wasted. (I've wasted training dollars before with practice management system conversions and need to be wiser this time around.)
• The final Webinar holds similar promise in addressing my third concern: implementation. How can I go from paper to electronic records without costing the practice an arm and a leg and me a pretty good marriage? How do I plan for the conversion? How do I avoid the weeks of unproductive downtime we so often hear about?

Will I still attend some of the free "meaningful use" Webinars from other vendors? At least one or two of them, I guess, though I don't think they'll help with what concerns me most. They won't help me prepare for my upcoming ARRAgeddon. For that, I am hopeful – even optimistic – that MGMA's series will be just what I need to cure my ARRAphobia and begin my migration to EHR.