The verdict is in. Doctors are massively abandoning the "meaningful use (MU)" incentives program. The program 1. imposes medical office software that is a lot more about constraining/tracking doctors than helping doctors, 2: forces providers to act as non-remunerated public health auxiliaries, 3: reduces the number of patients that can be seen, 4: imposes much higher staff qualifications, 5: places the providers under a permanent menace of compliance audits and 6. increases the overall operational costs to levels much higher than the incentives eventually obtained.
Government interventionism in general has caused a considerable drop in the number of private medical practices. A significant number of doctors accepting to become an employee or contractor in a corporate structure rather than continue the battle with the Government's health policies. This defensive move shows it's limitations too, because pretty soon these doctors discovered that, despite all the complicated payment formula's that are being used to make him/her believe otherwise, their income as an employee or contractor went way down and, in reality, even more unreasonable pressure is exercised from within those corporate structures. A number of doctors that went this route are back on the street nowadays because either the corporate structure in which they participated folded or decided that the doctor did not meet the business targets and as a result was terminated.
There is an alternative: keep private practice status and forget about MU, consider loosing MU incentives a 'business expense', and only look at what the Medicare/Medicaid programs actually represent in terms of the remaining business potential if properly processed with a system that works for the providers instead of the Government. Because - and that is the main problem with MU - the certified software vendors teamed up with the Government and the Insurance industry to impose software that actually works against the doctors. Being forced to run an obstructive software product, day in and day out, month in and month out, year in and year out, is actually the most costly and damaging part of participation in the meaningful use program. It is sort of revealing that getting a bill out of the door or uploading a claim is not considered 'meaningful use' of a medical office software product and, as a result, is not part of the MU criterion.
When the "Meaningful Use" and other government incentives were released, now several years ago, we, at EXmedic Software LLC, decided not to participate in the MU certification program. Instead of using development resources to satisfy the Government's 'control the doctors' objectives, we continued to improve our product from the perspective of the medical practice running it. We are now years ahead! The positive bottom line effect of running a non-government controlled medical office software product is considerable. Current or future CMS penalties can never fill that gap.
Our magic prescription for disillusioned doctors: 1. take a deep breath, 2. stay in private practice, 3. terminate Government certified software 3. concentrate on satisfying patients instead of the Government, 4. partner with EXmedic PM+EMR!
Cloud computing for medical offices is a buzzword that may sound somewhat impressive, but falls short when put into practice. Internet security is practically impossible to achieve without a heavy and costsly security burden on users and response times of web applications remain unacceptable.
Let's face it: a. Who would want to exchange a fast GB office LAN for a remote browser connection one hundred times slower? b. Who would place a crucial element of one's business system under the control of a third party? c. Who would allow protected patient health data under control of entities he or she never met?
And for what? Cheaper? Not really. Less hardware? No. Multi-user ease? Not really either, because the need for client stations and printers in the office remains the same. The only piece of hardware that can be saved is a server. A server nowadays is nothing more than a hard disk with an OS in it that does not even require a monitor. So what's the big deal? Offices running web apps have gone down for several days in a row. How cheap is that!?
It is our not so humble opinion that a native local area client/server system is far superior to cloud/web based apps no matter what the spin is. There is simply no comparison.
A web browser was not designed to be a business client data interface. By design it is a public page viewer/reader; period. This does not mean that non-crucial parts of an office system could not be made available from remote locations. Dedicated EXmedic clients connect over the internet without going through the 'hacker's paradise' layer of web browsers, without the risk of remote client connections being capable of bringing down the core in-house system.