Whether physician practices will be able to join health information exchanges once federal and state grants run out is a key issue given the high costs of running HIEs.
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This presents a thorny situation for practices that are contemplating joining statewide HIEs, because those entities are tasked with proving HIE technology is worth the financial backing from health care providers in the first place.
One such example comes from Colorado. Some physicians there are second-guessing whether to join the Colorado Regional Health Information Organization (CORHIO), which was made possible by $9 million in federal government grants. According to the Boulder County Business Report, the CORHIO wants each doctor to pay an $85 monthly subscription fee and $2,500 to $5,000 or more for staff training.
“What’s the value to us of this? We already have our interface,” said Kevin Joseph, technology director at Boulder Medical Center. “Down the road, the health exchange will be helpful, [but] we don’t have money to spend on this.”
Another issue facing physician practices is that meaningful use incentives are unlikely to cover the full cost of electronic health record (EHR) implementation. That, combined with the cost of joining a HIE organization, is too steep for physicians. It’s problematic, too, considering that stages 2 and 3 of meaningful use will likely require extra mandates on effective and accurate HIE.
Regarding the process of electronically wiring a physician’s office to connect to the CORHIO, Laird Cagan, president of the Boulder County Medical Society and a doctor at Frontier Internal Medicine in Longmont, noted that “it’s very costly, especially for small practices.” While he seeks to “improve care and reduce costs for patients through joining the HIE,” it’s not something that can be accomplished with a light wallet.