North Shore-Long Island Jewish Health System plans to offer incentives of up to $40,000 to its 7,000 affiliated doctors to migrate to digital patient records. The size of the program is significant and, along with federal subsidies, provides a competitive edge to the NY regional hospital system.

The incentives being offered by North Shore are in addition to the subsidies, up to $40,000, offered by the federal government as part of the American Recovery and Reinvestment Act passed earlier this year. Several studies have indicated, however, that there are significant barriers to migrating individual physician practices to e-records. The barriers include privacy concerns, training and cost of implementation. 

Another barrier has been lack of standards. The American Recovery and Reinvestment Act authorizes the Centers for Medicare & Medicaid Services (CMS) to provide a reimbursement incentive for physician and hospital providers who are successful in becoming “meaningful users” of an electronic health record (EHR).  These incentive payments begin in 2011 and gradually phase down. Starting in 2015, providers are expected to have adopted and be actively utilizing an EHR in compliance with the “meaningful use” definition or they will be subject to financial penalties under Medicare.

So while the efforts of North Shore will go a long way to help affiliated physicians in its system, there are still significant structural challenges to EHR adoption. Smaller physician practices, with physicians who are unaffiliated with hospital or other larger healthcare systems continue to struggle with those challenges.