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EMR Stimulus Myth #2: “I have a CCHIT certified EHR so I am good to go for meaningful use”

It is likely that CCHIT will be one of the accredited certification body under the EHR incentive program. HOWEVER, given that there is no formal EHR certification program available from ONC yet, no existing certification, including from CCHIT, means much towards meaningful use.

As I covered in EMR Stimulus Myth #1, even if you implement an ONC certified EHR (when the certification program is finalized), it does not get you to meaningful use. Providers have to meaningfully use the certified EHR and report on defined clinical qualify measures over a set reporting period to meet meaningful use. Given that no EHR today is certified, how should you proceed with EHR purchase decision?

If you are making the decision to buy an EHR now, YOU MUST VETT THE EHR VENDOR prior to purchase so that you minimize the risk of buying the wrong EHR. Vetting should include the assessment of EHR against the current definition of certified EHR from ONC plus the match of EHR to the makeup of your organization. Of course, any promises of future from the vendor should be baked into the contract you are executing with them. EHR needs of a solo or a small practice group is much different than a larger group/clinic/hospital.

People often find real value in getting the assistance of a meaningful use expert for this assessment. The pitfalls avoided make it worth the investment. You don’t want to purchase and implement an EHR and then find out your EHR won’t meet the meaningful use requirements. That would be a depressing realization.

About David:
David Lee is the Principal at eRECORDS, Inc.  David has provided successful healthcare technology, CRM and financial product consultancy for the past two decades and most recently, guiding healthcare organizations to “meaningful use”.   You can reach David at david.lee@eRecords.com or visit www.eRecords.com.

I meant to post this a long time ago and never got around to it. Although, I think it was one of the really interesting announcements at HIMSS. Here’s a portion of the press release from Quest about their EHR offering:

“Quest Diagnostics is making broadly available a Web-based EHR that helps physicians embrace digital healthcare one step at a time, connect easily with their peers on patient care, and achieve meaningful use that allows them to qualify for government incentives,” said Richard A. Mahoney, Quest Diagnostics’ vice president of Healthcare Information Solutions and president of its MedPlus healthcare information technology subsidiary. “We value the longstanding trust physicians have in our company, and we are proud to answer physicians’ needs with a modular technology that will truly help drive meaningful improvements in quality of care.” MedPlus develops the technologies that power the Care360 suite of physician offerings.

Each week I’m introduced to another interesting type of organization that’s trying to use their connections and relationships with doctors to sale an EHR. Who’s connections are going to win?

Of course, one question that will be interesting for Quest is how they’ll handle interfaces between their Care360 EHR and other vendors. I assume you’ll have to have a Quest lab interface as part of the deal. Does that mean all other labs are shut out? I can imagine that many doctors will be reticent to go with a Quest EHR if it basically locks them into a relationship with only Quest. It’s going to be interesting to see how this plays out.

Matthew Holt of the healthcare blog always does a nice job with his interviews. This is a pretty interesting one with Glen Tullman, CEO of Allscripts. Like it or not, Allscripts is going to play a big part in the EMR/EHR space. So, it’s worth listening to Glen to hear what he has to say about the industry.

One part that I found especially interesting was when he calls out Epic for not working on EMR interoperability. What’s interesting is that Glen really did look sincere in his desire for Allscripts to be inter operable. The problem is that I haven’t seen enough action in implementing those solutions.

Lots of other goodies in the video as well. Nice work Matthew.

One of my readers sent me the following email…

New England Journal of Medicine survey:
46% of primary care physicians would quit if Obamacare becomes law!

I’m not sure I agree with the statement. Should I? If this does happen, how will it affect the EMR industry? Should EMR vendors should be preparing for the healthcare reform (Obamacare) in their projections?

CCHIT has published their comments made on the Interim Final Rule (45 CFR Part 170, RIN 0991-AB58), published in the Federal Register of Jan 13, 2010, “Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology.” Or as I like to call it, the EHR Certification criteria.

Here’s 3 paragraphs that kind of describe CCHIT’s broad feedback on the EHR Certification criteria:

Before offering detailed suggestions, the Commission wishes to highlight three overarching concerns with the IFR as written:

• Scope. While “Complete EHR”sounds like a desirable certification, the package of requirements in the IFR may not match the needs and expectations of doctors and hospitals, nor the realities of the marketplace, for EHRs. By including two functions of an administrative/billing system in the scope of EHR certification, ONC may exclude one third or more of the offerings in the current EHR marketplace, while suddenly forcing hundreds of billing products to undergo unnecessary certifications. In other areas, the scope falls short of being complete: for example, an EHR that does not offer competent electronic management of progress notes would be unusable and medico-legally unsound, and an EHR that fails to prominently display patient advance directives in an emergency could compromise patients’ rights at their time of greatest vulnerability.
• Interoperability. The Commission and its expert volunteer panels believe that certain criteria and standards in the IFR represent a step backwards in progress toward EHR interoperability. For example, well-defined standards for receiving electronic laboratory results in the doctor’s office and for exchanging clinical summaries had already been recognized by the Federal government and widely supported by industry – as evidenced by the certification of over 80 EHR products to those standards in 2008. Yet under the IFR, that standard for receiving laboratory results, and the specific implementation guidance for exchanging clinical data, have been dropped. Where one standard was previously recognized for clinical data exchange, the IFR offers two different, incompatible standards. Conversely, other interoperability criteria in the IFR, such as the requirement that EHRs be capable of transmitting biosurveillance data to public health authorities, could immediately increase EHR cost and complexity while benefits remain years away because public health authorities lack standards-compliant infrastructure and systems for receiving that data.
• Functionality. Some of the IFR criteria define required functionalities of an EHR too microscopically, adding unnecessary complexity and creating barriers to innovation. Other criteria are too vague to be reliably verified in a testing process, creating a risk that the expectations of providers, payers, and the public regarding the performance, safety, and benefits of Certified EHRs will not be met. A particular concern surrounds the reporting of quality measures, with the IFR calling for standards and measures that are yet to be defined or that require significant revision to make them computable from EHR-based data.

I’ll be interested to hear people’s comments about CCHIT’s feedback on the HHS EHR Certification Criteria.

I’m still working through some of the various wrap ups from HIMSS that I’ve found. Matthew Holt is always an interesting blogger. Turns out that he’s even more interesting in person. Here’s a few of his thoughts that I think are worth sharing:

Busiest booth?: I think Cisco wins. Maybe it was HealthPresence, maybe the magician—but it was always packed. What I think it means is that mainstream Internet tools are now coming into health care (with some little tweeks). But as MrHISTalk says, putting all the big guys in the A hall was a mite unfair on the C side—although I got to both a little.

Most intruiging announcement?: Epocrates will release a hand-held and web-base EMR app for the iPhone and other handhelds. Why is that interesting? Because they already have 275,000 docs actively using their tool on a handheld, most on iPhones. If their tool’s any good you have to assume they have a great marketing advantage. If this succeeds there’s no way they remain independent in 18 months.
…
Most interesting niche company you’ve never heard of whose CEO you randomly met at a party?: LiveProcess is a SaaS-based emergency preparedness tool. (I think CEO Nathaniel Weiss said) it has 500 hospitals paying $10K a year each with no customization.

Other interesting niche company?: CPM does CRM outbound marketing for hospitals and as nearly doubled in size during the downturn (video of them to come).
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Most interesting philosophical chat?: Andy Weisenthal of Kaiser Permanente discussing how specialists are going to change entirely what they do now that everything in KP is online. One Hawaii endocrenologist is on a jihad to prevent diabetics ending up on dialysis—he’s completely reorganized how primary care docs treat their patients. It’s almost like his goal is to put himself out of a job. Andy said about Healthconnect’s finalization of the $6bn (?) implementation—”It’s not the end, it’s the start”.

It’s also worth linking to Matthew Holt’s interview with Epocrates about the Epocrates EHR. Although, I also just remembered I could embed it below:

I was glad that I had at least one chance to talk with a vendor about Smart Cards at HIMSS. Sure, smart cards have been around for a really long time, but I wanted to see what was happening with this relatively old (25 years or so) technology.

Well, I had a chance to do this video with Gemalto to talk about Smart Cards in healthcare and also the possibility of your cell phone becoming your smart card. Could be really interesting to see that evolve. Check it out:

This video coverage of HIMSS 10 sponsored by Practice Fusion and their Free EMR.

Ever since I first saw Fred Trotter’s post about CONNECT being the future of EMR interoperability, I was really interested in the open source software CONNECT. Of course, when the PR person from ONC emailed me with an opportunity to talk with someone from ONC, I jumped at the chance.

The following is a short video where I tried to capture what ONC is doing with NHIN and CONNECT so that people can be more informed on these 2 projects. I hope you enjoy:

This video coverage of HIMSS 10 sponsored by Practice Fusion and their Free EMR.

I rated the HISTalk party at HIMSS as the Wildest party in my Best and Worst of HIMSS post on EMR and HIPAA. No doubt the HISTalk party was an event to remember with a lot of really influential people there. However, probably the best part of the night for me was this Meaningful Use rap by Mr. HIT. I can’t imagine how much he practiced this since he did this 2.5 minute Meaningful Use rap flawlessly with no notes. That’s impressive. If you read this blog regularly, I think you’ll enjoy it too:

I always love when people are interested in doing guest posts on this site. This is going to be the first in a series of blog posts about some of the misinformation that’s out there about the EMR stimulus, certified EHR, and meaningful use. I hope you enjoy!

My name is David Lee and I am a principal of a healthcare technology consulting firm called eRECORDS, Inc. Day in and day out, I talk to independent physicians, practice group owner and community clinics about HITECH Act and “meaningful use”.  My company takes pride in providing accurate and up to date information to the physicians and clinics so that they can make intelligent decisions about meaningful use.

I am continually amazed at the misinformation surrounding meaningful use and the one that scares me more than anything else is ”My EHR vendor told me that if I implement their certified EHR, I will meet the meaningful use requirements and collect EHR incentive payments.”

It is true that a “certified EHR”  is a key component to meeting the requirements of “meaningful use”.  However, a “certified EHR” is not the silver bullet to meaningful use.  Let me share some important facts:

• Fact: Although the definition and requirement of a certified EHR has been released by the ONC, there is no organization recognized or approved by the CMS to certify EHR to meet the requirements of the meaningful use criteria.
• Fact: Even if your organization implements a certified EHR (when certification bodies are appointed and your EHR vendor passes the certification), this does not get you to meaningful use..
• Fact: Meeting meaningful use requirements involve qualified providers meaningfully using a certified EHR and reporting clinical quality measurements.  The key words are “meaningfully using” and “reporting” not simply having a certified EHR.

Don’t be fooled by any vendor claiming that they are certified or promising they will be certified.  Although some EHR vendors are better prepared to meet the certification when available, not a single vendor today is certified for the EHR incentive payment program.  More importantly, you cannot meet the requirements of “meaningful use” by simply implementing a certified EHR. It is vital that you find experts who can provide accurate assessment and plan for “meaningful use”.

This is a continuing series where David will share and hope to clear the myths about HITECH Act and “meaningful use”.

About David:
David Lee is the Principal at eRECORDS, Inc.  David has provided successful healthcare technology, CRM and financial product consultancy for the past two decades and most recently, guiding healthcare organizations to “meaningful use”.   You can reach David at david.lee@eRecords.com or visit www.eRecords.com.