Managed Services Organization or - MSO
'Also Medical Services Organization
1) Traditional 'ASP' model. For profit, non-shared
2) Donation - Becoming more popular as a result of relaxation of the Stark Physician referral law and Anti-Kickback Statute Hospitals may donate up to 85% of the cost of implementing an EHR.
A health system in the Eastern US is taking advantage of the recent Stark relaxation rules and is in the process of opening up their Electronic Health Record to private physicians in the community.
The heath system is comprised of two hospitals and a multi-specialty medical group. They purchased additional licenses for their TouchWorks EHR and are opening up the EHR to private physicians in the community.
To date, the response from the community has been enthusiastic. For one, the specific product suite that is being rolled out would normally be out of reach for a small, 2 physician practice, and when you factor in the Stark adjustment, patient care benefits, it quickly becomes a winning proposition.
Since the health system is already live on the EHR, practices get the local expertise, use of existing templates, and installation support. And because customers are literally using the same system, they get all the benefits of redundancy, security, and a world-class datacenter. Where else can a 2 physician practice get enterprise level support and attention? They get all the benefits of being with a large organization (Purchasing power, vendor attention) while still remaining independent.
This health system is creating a community health record where each provider along the continuum of care works from the same record. In addition to the obvious benefits to patient care, there are great administrative efficiencies to be gained. For example, instead of a physician faxing a referral request, she could simply generate a ‘go to note’ task that references her office visit note in the chart.
In this part of the country, there are no other health systems poised to have a similar offering, so the primary competition is from smaller vendor players. It is not hard to imagine a tipping point where those who have not joined are at a significant disadvantage.
The concept has been well received in the community. There is a very different dynamic when one doctor explains to another doctor, with refreshing candor, how the EHR works and where it falls short. From the unpolished demos with brutal honesty, physicians quickly recognize that this is not a typical vendor sales presentation but rather a community project where everyone’s incentives are aligned.
All in this together
The private practice sees immediate benefit because the medical group has already invested significant resources in selecting, implementing and maintaining an enterprise EHR for its 400 physicians. The incentives are perfectly aligned.
The remarkable thing about this initiative is that it is a fully shared record where all providers work exclusively from a shared patient record, update the same medication list, allergy list and problem list, etc