Want to avoid an expensive misstep when shopping for an EHR? Look for unbiased advice and go with your gut, says Deanna Attai. The Burbank, Calif., breast surgeon says she didn’t know that the EHR vendor she selected had paid for its glowing references. Worse, she didn’t follow her instincts. She has spent an additional $30,000 so far replacing that feature-rich system that never panned out.

Attai has a different system today but also more wisdom. “I should have listened more to my gut and not been distracted by the bells and whistles they promised but didn’t deliver,” she says.

With the government now offering cash incentives for implementing an EHR, many physicians who’d long held out have had their interest piqued, even as others remain skeptical, according to the 2010 Physicians Practice Technology Survey.

More than half (57 percent) of the 597 respondents to our survey told us that the Medicare and Medicaid-based incentive programs set to launch in 2011 make them more likely to buy an EHR. Getting cash from the federal government to defray the cost of an expensive purchase sounds appetizing. But like most lunches, this one really isn’t free; Uncle Sam isn’t offering to take you EHR shopping. Only after practices front the money to buy a “certified” system and follow the just-finalized rules for demonstrating that they are meaningfully using it can they seek federal stimulus dollars. And these facts have most physicians still puzzling over how the whole program will work.

We’ll help sort that out as we take a closer look at this year’s technology survey results.

The HITECH act

First, some recent history.

The EHR incentive program was created by the Health Information Technology for Economic and Clinical Health Act (HITECH Act), part of the federal stimulus package signed by President Obama in 2009. The legislation provides incentives to each physician (and certain other providers) who meet HITECH’s requirements. You can participate in the Medicare or the Medicaid incentive program, but not both. Switching between incentive programs after you start is allowed, but only once.

The legislation sets four objectives for physicians to get the stimulus money. You must:

• Use certified EHR technology in a meaningful way;

• Utilize electronic prescribing;

• Use a system that electronically exchanges health information to improve the quality of care; and

• Submit information about clinical quality and other measures.

To meet that first bullet, the Centers for Medicare and Medicaid Services (CMS) sets 15 mandatory requirements for eligible providers (and 14 for hospitals) to meet in 2011 and 2012. Eligible providers and hospitals also must meet at least five additional measures of their choosing from a menu of 10 requirements. CMS plans to raise the bar by adding more criteria in subsequent years of the bonus program.