"What we do is very scalable. Any number of community hospitals could share in an environment like ours," he said. "I think if the government were to fund some type of regional data centers, it's probably money better spent than giving hospitals money to figure out how to do it."
In order to justify the cost of an in-house, client/server EHR model, physicians should tackle EHR projects in groups of three or more, according to Bell.
IDC's Hanover recommends that, before rolling out an EHR system, physicians and clinics should first perform a gap analysis to determine what they currently have and what they still need in order to roll out the new system. They should consider what technology will be required to support their service goals, and they should take into account both near-term and long-term meaningful use requirements as well as their the future patient care goals. Only after doing all of that should they put together a request for proposals for vendors.
Gartner's Handler suggests that healthcare providers should also consider processes and protocols -- in other words, they should figure out how to standardize technology rollouts from physician practice to physician practice and hospital to hospital in a group. Also, they should consider whether they need functions such as order sets as part of a computerized physician order entry system with prefilled ordering templates.
The Office of the National Coordinator has established 66 Regional Extension Centers, or RECs, throughput the U.S. for the explicit purpose of helping physician practices and rural clinics roll out EHRs.
RECs were created last year under the Health Information Technology Economic and Clinical Health (HITECH) Act. For the most part, the RECs don't provide healthcare providers with any funds, but they do offer training and technical assistance in rolling out computer systems. Each REC has 10 to 30 employees, depending on the size of the region in which it operates.
The U.S. government also issued $144 million in grants to create college courses to train people and help fill an estimated 50,000 jobs needed to assist doctors and hospitals as they roll out EHRs. However, none of that money covers the cost of EHR hardware and software -- the most basic costs associated with health IT.
Another reason to wait
Bell said physician practices and clinics that haven't begun implementing EHRs may get a system that truly suits their needs -- and meets federal meaningful use criteria -- later on.
By waiting until 2012 or 2013, healthcare facilities can ensure that they are preparing to meet both Phase 1 and Phase 2 meaningful use requirements.