The ACS is getting more engaged in an effort to help surgeons cope with the deadlines, he added. Surgeons who haven't started on any of these programs first should carefully analyze the reporting periods for all of the incentives and penalties when prioritizing which program to begin first, according to information provided by the ACS health policy division. "For example, this is the last year you can begin the stage 1 of the EHR incentive program to be eligible to receive the full incentive bonus of $44,000. The first 6 months of the year is also one of the reporting periods to avoid getting the 2013 eRx payment penalty," according to the ACS.
The time and money involved also should play a role in decision making. Keep in mind that the eRx and PQRS programs both have relatively low start-up costs, and do not take a long time to begin.
More Information
The ACS provides information focused on each quality program -- eRx, HER, and PQRS -- where surgeons can find resources such as flow charts and step-by-step guides to help lead them through the process of implementation:
-- ACS Division of Advocacy and Health Policy: www.facs.org/ahp/index.html
-- EHR: www.facs.org/ahp/ehr/index.html
-- eRx: www.facs.org/ahp/erx.html; www.facs.org/ahp/erx-exemption.pdf
-- PQRS: www.facs.org/ahp/pqri/index.html
However, "if you get into this, you will need to have someone in your group really spend some time with it," Dr. Detmer cautioned. In addition, he noted that there can be long waits for installation of popular products, which surgeons need to keep in mind while considering when the EHRs need to be operational to avoid CMS penalties.
In general, institutions are much further ahead on EHRs than are surgeons practicing solo or in small groups, Dr. Detmer said. "Most people who are in an institution or large system are typically well into this at this point," he said. "If they haven't made the move to [electronic] order entry, they're doing it right now."
In institution-wide efforts involving multiple specialties, "surgeons don't necessarily have to lead, but surgeons will need a champion as part of the process," he added.
With the new subspecialty certification in medical informatics now available, "there really is a need for some young surgeons to decide they need to be part surgeon, part informatician," Dr. Detmer said. "We have some good surgeons involved in this, but not the numbers we need."