As the HIMSS (Chicago) conference was winding down in New Orleans this week, GE Healthcare (Waukesha, Wisconsin) released study results concerning physician attitudes toward Stark Relaxation the "Stark" Physician Referral law and Anti-Kickback Statute based on data obtained from an independent study.
It said that the study reveals that Stark Relaxation could greatly accelerate the adoption by physicians of electronic medical record (EMR) systems and could as much as double the number of physician practices willing to acquire or upgrade an EMR system within the next year.
In 2006, the Department of Health and Human Services, through its Centers for Medicare and Medicaid Services and Office of the Inspector General, created new safe harbors and exceptions to the regulations implementing the Anti-Kickback Statute and the "Stark" Physician Referral law. These rules, before the recent modifications, had limited hospital financial support for physician implementation of EMRs.
Mike Raymer, VP/general manager, Product Strategy and New Business Initiatives for GE Healthcare Integrated IT Solutions speaking to Medical Device Daily from the HIMSS conference said that the acceleration of EMR adoption by physicians is, in part, a product of a "fundamental shift" in how physician systems are procured over time.
GE Healthcare commissioned an independent market research firm to conduct a blinded study of 200 physicians in small, medium and large practices to identify what effects Stark Relaxation may have on adopting or upgrading EMR systems over the next 12 to 36 months. Raymer said that the GE survey was conducted to help it formulate "a business strategy responsive to what the market needs."
He said that one of the surprises from the study was the degree to which physicians chose hospitals as the preferred source as a "donating entity" of EHRs.
"The hospital as a preferred donating entity was certainly a big spike," Raymer said, noting that this choice "fits well with GE's dominance in the hospital" market. Also physicians indicated that they want a system "that is not co-mingled with the in-patient solution."
GE's EHR solution is branded "Centricity," and during the conference the company featured the Centricity Continuum of Care pavilion to showcase the components of its overall solution offerings.
Raymer noted that Stark Relaxation allows hospitals and other entities to provide EMR technology to physician practices "at a subsidy of up to 85%, [so that] physicians are now better positioned to implement these comprehensive systems..."
But regardless of the opportunity to acquire or upgrade an EMR system for a fraction of the actual cost, physicians continue to cite acquisition cost as their highest concern, according to the study.
"Technical support, maintenance costs, and training are a few of the issues donating entities should take into consideration when designing a donation program [under Stark Relaxation]," Raymer said.
Raymer noted that respondents significantly preferred to receive an EMR donation from a local hospital or integrated delivery network rather than from an insurance company, regional health information organization (RHIO), EMR vendor or pharmaceutical company.
In addition, most physicians were willing to have the EMR hosted on a hospital's server. Such a hosted option can reduce ongoing support costs and eliminates the physicians' need to acquire additional hardware, which cannot be donated under the new rules.
"The majority of physicians are unwilling to share financial data with the hospital," said Raymer. "Hospitals offering independent systems will likely, therefore, offer a substantial advantage."
The study also addressed the attractiveness of standalone e-prescribing systems as an incremental approach to IT adoption vs. integrated e-prescribing EMR systems. Most of the respondents (61%) did do not see e-prescribing as a viable "first step" toward implementing an EMR, but rather that integrated EMR/e-prescribing would minimize disruption caused by new workflow implementation.
"There are clearly some issues and concerns that still need to be addressed by donating entities when considering Stark Relaxation," said Raymer.