EMR enticements: What will it take?

Physicians have been slow to respond to existing programs offering a bonus for implementing electronic medical records.

By Tyler Chin, AMNews staff. Dec. 13, 2004.

After having only two takers in nine months, the 728-doctor Hawaii Independent Physicians Assn. this fall shut down its program to give $3,000 to any member who implemented an electronic medical records system.

In October, WellPoint Health Networks reported that 19,000 out of 25,000 physicians in four states participated in its $42 million initiative to give physicians a personal digital assistant-based e-prescribing system or a desktop-based paperwork reduction system. But only 2,300 selected the PDA-based clinical system.

Since August, the 150-doctor Central Massachusetts Independent Physician Assn. (CMIPA) and Fallon Community Health Plan have offered $5,000 to physicians who buy an EMR. If 10 to 15 doctors step up, the IPA and the plan will be happy.

As these examples show, the use of financial incentives to induce physicians to buy and implement EMRs has not been a smashing success. Many entities believe that physicians will adopt EMRs if the money is right, but the question remains -- how much money will it take? And is money enough to persuade physicians to adopt the technology?

Most current financial incentives for EMR adoption take the form of pay-for-performance programs under which health plans and self-insured employers offer annual bonuses to physicians who meet criteria composed of a combination of clinical, patient satisfaction, administrative efficiency and information technology measures.

There are approximately 80 pay-for-performance programs nationwide, said Beau Carter, senior health policy and strategy consultant at MedVantage Inc., a San Francisco-based consulting firm that focuses on quality bonus initiatives. Their sponsors' hope is that the financial rewards available to physicians will inspire them to buy EMRs, which proponents say make it easier for physicians to compile and present information necessary to receive their bonuses.