As most readers know, it took what felt like an eternity for the IRS just to come out with it and say how it felt about non-profit hospitals' plans to make EMR donations to physicians. So complex and mighty is the IRS that even its "yes" doesn't appease everybody--so its memorandum on the subject, while helpful, hasn't exactly led to a rush of free or low-cost EMR rollouts. Still, it has gotten the ball rolling.

Now, it's looking like yet another promising, if slow-moving and costly, movement could get caught up  in the IRS gears. If you read the entire Modern Healthcare story [1] excerpted below, which talks about how not-for-profits are finally starting to give away EMRs to doctors, you'll see the problem. In a small aside, the story notes that the groups behind some RHIOs have begun to ask the IRS for guidance on what they can and cannot do to build their networks.

Their worries seem more than justified. After all, if they want to put an effective health data sharing organization in place, the non-profits getting involved in RHIOs may have to give away or subsidize a few technologies. Depending on how their network is configured, it may be enough to supply EMRs and follow the existing rules--but maybe they'll need to supply additional gear and software as well. At that point, arguably, the water gets murky again.

With any luck, this issue will be addressed faster than the EMR issue was. I hold out some hope that it will, given that IRS officials (who are, after all, human) may simply feel that they've worked some of the key issues out for themselves already. But it remains to be seen.

Folks, here's hoping that one of the world's most ponderously slow agencies decides to go into overdrive this time. With many RHIOs struggling to stay afloat financially, an indefinite series of delays could be deadly. - Anne [2]