It’s not often that we interview vendor executives, but when I saw GE’s plans to offer providers interest-free funding for its EMR (acute and ambulatory), with payback schedules pegged to HITECH disbursements, it piqued my curiosity. After all, one of the main weaknesses of that legislation is the lack of up-front funding for cash-strapped healthcare organizations. Eager to learn more, I set up an interview with GE HealthcareIT’s head man —Vishal Wanchoo.
GUERRA: CCHIT recently released its proposal for creating three paths to certification. Do you have any initial thoughts on that?
WANCHOO: This is a difficult one to navigate through, and the background on this is that there are health systems that have different kinds of technology, some of which they may have homegrown, some that they’ve pieced together, best-of-breed systems, etc. Those organizations may actually be doing great work in terms of delivering great healthcare through the use of this technology. A lot of these organizations have raised a hand and said, ‘Technically, we're not using a certified product which is in the law, so we don’t qualify and that’s a problem because we are actually achieving meaningful use.’
So that’s where this is stemming from and there’s a lot more discussion that will take place on this one. We’ll have to figure it out because it is more complex, it’s more complicated, and it may go against the grain of what the government wanted, which is you have to use a qualified and certified EHR. And now you’ve got a component that’s qualified and the rest that’s not; it does raise some red flags or some concerns.
GUERRA: From what I see, CCHIT would be taking on a very expanded role, requiring incredible amounts of staffing if they are going to move away from just certifying products against specific criteria to certifying clinical environments.
WANCHOO: I think you hit the nail on the head on that one. This is something, as I said, we’ll have to really work through. There is going to be a lot of input on this one, as you can imagine. There are a lot of stakeholders and you’re right, certifying sites is not going to be easy. Today it is about certifying EHRs, and I think we have that down to a pretty good process. We’ve got a checklist that we go through, and it works fairly well.
GUERRA: Let’s talk about GE’s involvement in the process going on today. I noticed that three of the big vendors have representation on these committees. Judy Faulkner (Epic CEO) is on the Policy Committee, David McCallie, Jr., from Cerner is on the Standards Committee and then I just noticed that Charlene Underwood from Siemens is on the Meaningful Use Workgroup that reports to the Policy Committee. Does GE feel left out?
WANCHOO: We don’t have any GE representatives on the Policy and Standards Committee, however we do have our partner on there who is really an extension of GE, both the Policy and the Standards Committees. So we’ve got Mark Probst who is the CIO from Intermountain Healthcare on the Policy Committee and we have Stan Huff (Intermountain) who is really, I would say, the guru of standards and probably the most prominent medical informatics leader in the country, he’s on the Standards Committee. As you know, we really are a joint R&D team between Intermountain and GE in Salt Lake City, so we’ve got our R&D team imbedded with theirs in Salt Lake and actually in the hospital setting there. Like I said, we feel good about our representation.
GUERRA: It just didn’t quite make sense to me why three of what I would call the top seven vendors in healthcare IT have representation and the others don’t.
WANCHOO: Yes. We don’t either, but there was some process that took place and we did obviously submit names from both GE and Intermountain Healthcare into both the Policy and the Standards Committee and that is what came back. I actually don’t know what process they applied.
GUERRA: Right. So you do the best you can to stay involved.
About the stimulus funds, I have one more question on that. You’re talking about getting paid back essentially for your products from stimulus funds. Isn’t it certainly possible that what the customer owes you will be far more than they will reap in HITECH benefits?
WANCHOO: The obligation really for the customer is to repay for the system that we’re providing, so it may or may not cover it. In fact, it is very likely the stimulus funds are not going to match exactly what the cost of the EMR is. I mean, that’s not the intent of the stimulus certainly. The stimulus is designed to stimulate adoption, so it wasn’t designed necessarily to provide a 100 percent reimbursement for any EMR system.
Now in some cases it might, depending on if you are a very small clinic, potentially, it could cover it. So it all depends. For a large hospital, it probably will not, but the contract with the customer obviously is that — they’re really buying the EMR from GE for a certain price, and that’s going to be subsidized by the government. And whether it’s 100 percent subsidized or 50 percent, it all depends.
GUERRA: Do you have any advice for our CIO readers?
WANCHOO: I think the advice I would give is that they really need to have an organized effort to understand how they would become a meaningful user. What I’ve seen is a wide variation in terms of organizations that are aware of it, but they haven’t really put an organized effort around it. Other organizations have gotten in front of it, they have actually hired consultants, bought in companies like CSC or Accenture, etc., and gone through a very thorough analysis of what they need to do, how they need to prepare and what’s the potential reimbursement that they could get. So some organizations have a very good understanding of what it’s going to be and when you actually do that, it mobilizes your efforts because in some cases, the reimbursement could be substantial.
On that point, I think the suggestion I would have is that you put someone in the organization in charge of this whole process, a leader that can guide you towards meaningful use.