Physicians want hospitals' help covering new IT costs

Chicago -- With the drumbeat building for greater physician investment in information technology, the AMA's House of Delegates passed a resolution pressing for physicians to be allowed greater flexibility in how they finance it -- such as getting assistance from hospitals, as long as they don't try to wield power over physicians as a result.

The House, during the AMA Annual Meeting in June, passed a resolution urging the Association to support legislation and other "appropriate initiatives" providing incentives for physicians to acquire health information technology. That includes pursuing legislative and regulatory changes that would "otherwise prohibit financial assistance to physicians" purchasing technology.

The resolution also called for the AMA to support initiatives promoting interoperability between systems.

Because of current Stark and anti-kickback laws, generally physicians cannot get any financial assistance from a hospital for information technology, even if part of the goal in implementing technology is better communication between the physician and the hospital in question.

Supporters of the resolution testified that physicians have great need for financial assistance in acquiring health IT not only because of the eye-popping price tags of the systems, but also because of the potential for significant costs while implementing the technology.

"The changes that have to take place in your office are also expensive," said internist Josie Williams, MD, a delegate from College Station, Texas.

She added that the implementation period can drag on for more than a year, meaning the potential outlay of costs can persist for a while.

Dr. Williams, whose Texas delegation introduced the resolution, said financial assistance also should come from other outlets in addition to hospitals, such as low-cost loans and tax incentives.

It was noted that the AMA already was supporting or pursuing legislation addressing the issues of getting exceptions to Stark and anti-kickback rules for financing health technology, as well as working in collaborative efforts to develop standards that would allow for greater interoperability between disparate systems.

Supporters said the new resolution was aimed at bolstering existing policies and advancing advocacy efforts in health IT.

The resolution was amended during the meeting, however, to reflect physicians' concerns that those who would help physicians finance technology might want an undue amount of payback.

In testimony before a committee considering the resolution before it was voted on by the House, Thomas E. Sullivan, MD, an alternate delegate for Massachusetts, said that if such advocacy efforts succeed and more hospitals start assisting physicians, aid might come only on the hospitals' terms.

The Beverly, Mass., cardiologist said scenarios already had played out in several states where hospitals were able to help physicians with financing information technology.

For that reason, he introduced amendments that called for the AMA to support the principle that when financial assistance for health IT originates from an inpatient facility, it shouldn't unreasonably constrain the physician's choice of systems and shouldn't promote mandatory sharing of protected health information. That was adopted by the full House as part of the health IT resolution.

Having a choice of at least a few systems is key to ensuring that physicians can acquire the right technology for their practices, Dr. Sullivan said. And making sure that physicians and patients control the data in the systems is the best way to avoid breeches of patient privacy and confidentiality, he added.

Dr. Sullivan isn't getting help from a hospital in his own solo practice as he adopts a new billing, scheduling and electronic medical record system that will likely cost something "in the high five figures," he said, though he did secure a discount from a vendor.

Still, he believes it's a worthy investment. "If I didn't believe in it, I wouldn't buy it," he said.