By JONATHAN BUSH

Earlier this month I read in The New York Times (okay, someone read it to me), that hospitals and docs are saying “meaningful use” is just too much, too fast. I have to say, I would sympathize . . . if I didn’t know about the Internet!

If someone told me that the federal government was going to make (or at least ‘encourage’) everyone commute via hot-air balloon by 2011, I’d start to feel edgy right about now. How do you make or buy one? Who sells them?  What if the wind blows the wrong way?

This would be my panic—unless I knew about a little-known hot-air balloon service that DEALS with all of it. Like a taxi service. You tell it where you want to go and when and then boom! a balloon shows up piloted, prepped and ready.

Such a quandary exists in the EMR market today. Everyone thinks the government rules mean that meaningfully using electronic health information actually means meaningfully using information you BUILD YOURSELF! They think you have to buy EMRs and servers and program them to meet government rules and then re-program them to meet rule changes. This would give me hives, even if I were a giant health system. Even systems with big budgets don’t have a comparative advantage in programming software!

The result is that many, many practices are getting out of Dodge. I haven’t seen as many practices for sale since 1995 when the explosions of PhyCor and MedPartners caused practices to sell to hospitals in search of AR support. In a poll we did recently with Sermo, 60% of responding docs said they were considering selling out to bigger entities! Even if the industry is moving toward easier-to-manage options with “hosted” software, many versions need to be upgraded, and the government (and payers, and associations who create protocols of care) all keep changing. It’s too hard to keep up with the complexity, and that’s why physicians are selling their practices.

Similarly, hospitals are now trying to facilitate “health information exchanges” and they’re setting them up and trying to fly them. Whew! If I was in the middle of the air and the New York Times called me, I think I’d also feel like the Charles Grodin character in the movie “Midnight Run.” See below starting at about 0:55.

Okay, this is sounding so shamefully obvious…use a web-based service !

Why? Our web-based service allows us to respond to any changes from Washington. We can patch rules out nightly to all our clients if needed. We have an intelligence team that monitors all proposed changes to meaningful use and works with our EMR developers to make sure we comply. Finally, our back-office services help physicians enroll in the stimulus programs, collect payment, and report on necessary clinical measures. We not only run the balloon service but we run it in the “cloud” (sorry, couldn’t resist)!

Oh, and I am so confident our clients will meet meaningful use with a web-based service that I am guaranteeing their first government incentive check. You can even read the fine print if you want.

In other words, don’t build meaningful use – USE IT!  This is not lost on people because we see a lot of hospitals attempting to build their own information services! The problem is that they are BUYING legacy software and attempting to make it look like a service. Yeesh. (Citrix WinFrame anyone?) Aside from the clunkiness of making legacy software quack like an online network, there is the cost . . . but I’ll save that rant for another day.

Jonathan Bush co-founded athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. He obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School.