Taking advantage of the relaxed Stark rules and subsidizing the purchase of electronic health records technology may seem enticing to hospital executives. But as one speaker at the HIMSS 2010 Conference pointed out, it is a journey health systems must take with caution.

"Do you have the fortitude to become a vendor?" asked Elise Spoto, director of information technologies and physician practice solutions, at Sentara Healthcare. Spoto described how Sentara is taking advantage of the Stark exception by offering to host an ambulatory EHR system for physicians.

The rewards, she said, are many, including improved quality and safety through easier data sharing with physicians. And physician relations can improve as well. But the risks are real as well. By agreeing to subsidize the technology, the hospital in essence becomes a software vendor, she noted, especially in Sentara's model, in which the health system hosts the software for physicians.

Figuring out the upfront costs of server support, license cost, and implementation expenses is critical.  Beyond that are ongoing costs of maintaining the hardware and running an expanded I.T. department to support the expansion. Based in Norfolk, Virginia, Sentara comprises eight hospitals with 1900 beds.

--Gary Baldwin

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