skip to Main Content

The Hidden Cost of “Free” Software

Written by: Shawn Hewitt on Thursday, September 28, 2017 Posted in:

In the always-present quest to ensure that your organization is utilizing software with value-added features and workflows, there are many factors to consider. Let me focus on just one of those considerations today — the one consideration that drives most decisions for healthcare organizations — cost.

You’ve probably heard the expression, “You get what you pay for.” I also remember my high school economics teacher always saying, “There is no such thing as a free lunch.” I think you can sense where I am going. There are some hospital-wide solutions that claim to offer a “free” rehabilitation module with the larger purchase of the full hospital system. In this case, free does not always mean free. The purchase may not require any dollars on the front end, but what often happens is the cost is shifted — in the form of effort, time, productivity, and overtime. That means that “free” could end up actually being very costly.

A scenario to help paint the picture

You are a director of rehabilitation who has a great departmental clinical rehab solution that meets the rehab team’s every need in regards to operational and clinical management of patients. One day, your CIO communicates that the hospital has decided to purchase one of the big EMR packages to reconcile costs across the business units. You have seen this before. Often, implementation of a big EMR means the rehab department is last in line and forced to use something that does not meet the needs of rehab management. This time you are told, “Don’t worry; you will not be forgotten. The EMR has a free rehab module,” says the CIO. On the surface, this sounds enticing. Who doesn’t want free stuff?

What does this really mean to you

Maybe you’ve already been through this scenario yourself. Perhaps you are feeling this pressure and realize it is only a matter of time. Is “free” a happy word in this situation? What does free really mean, and what type of solution are you actually getting?

The “free” rehab module is usually thrown in by a vendor to help reduce costs of buying the new hospital-wide system. This investment is mainly focused on meeting the needs of the larger acute-care departments. If the vendor intended to develop and update a rehab module, it would most likely not be free. You may end up implementing a set of vendor rehab templates which turn out to be a step backward from where you are today. Invariably, those templates lack the specificity and customization of a rehab-specific solution that they might replace.

After the design effort, you’ll spend time working through a workflow alignment phase to learn how to use the system to meet some of your ongoing needs—which you never had to worry about before. When the next set of CMS changes rolls around, you will join the list of projects asking for IT resources. What this means for you is that, for the foreseeable future, you may be on your own to deal with the constantly changing regulatory requirements of post-acute rehab.

Now, I am not coming down on any CIOs out there. CIOs are in tough spots, trying to balance system consolidation, reduce costs, meet accountable care initiatives, keep staff happy, and provide quality patient care. However, these types of decisions often result in the transferal of upfront purchase costs directly to your business unit, requiring your rehab team to expend cost and effort supporting that “free” rehab package.

Here is a sample breakdown:

  • Costs for monitoring and managing CMS compliance
  • Costs for interpreting CMS requirements and designing what those requirements may be to build into your system
  • Costs of development and testing new requirements
  • Cost for implementing new requirements
  • Cost of training and communicating impact/change to workflow

Now, for anyone who waits with baited breath for the proposed and final rules, you realize that a lot of time is needed to understand, plan for, and implement the changes. Even if you can get some IT resources, the development cycle for these EMR systems is often incompatible with the 6-month or so window you have. Due to the system’s complexity and requirements for interoperability, the design and deployment window is often closer to 12 to 18 months.

Missing the date and the new requirements are a big deal! The consequences would be penalties, denials, and not getting reimbursed for the care you provide. That’s not an option. This is the risk that you have to manage to go along with the transferred costs of the free software.

It doesn’t have to be like this

There is another path that is completely in line with your CIOs desire to standardize documentation and interoperability on a single EMR. Mediware offers solutions and services that allow you to outsource the ongoing cost and risk of maintaining compliance with the changes being driven by CMS. Mediware’s MediLinks for Rehabilitation solution integrates seamlessly with your institution’s EMR system while also offering rehab-specific features and workflows for management of compliance, collection of outcomes, and protection of revenue, all while offering efficiency to the rehab team.

Final thoughts

There are several clear-cut reasons to consider an outsourced best-of-breed rehab compliance solution.

  • Required changes have a short gestation period, and the EMR platform requires a long development cycle.
  • Accessing IT resources for the rehab team is often difficult, especially when IT is typically utilized to pursue hospital-wide strategic goals.
  • IT often lacks post-acute, rehab-specific domain expertise.
  • The rehab department does not have free resources to serve as IT analysts who can design needed to address the changes.
  • An outsourced best-of-breed alternative can be purchased for minimal cost.
  • Outsourcing provides a stable cost structure that supports other strategic fiscal planning objectives.

If you think your rehab department would benefit from this kind of operational and fiscal streamlining, we’d love to talk to you. Our rehab experts can help you identify the benefits of managing the costs and risks associated with compliance without invalidating your strategic direction with a whole system-wide EMR. By taking charge of the conversation proactively with your CIO, you may be preventing a return to the dark ages of pen and paper.

Back to top