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Should EMR Vendors Care If Patients Get Their Records?

Posted on August 11, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, Epic CEO Judy Faulkner and former Vice President Joe Biden reportedly butted heads over whether patients need and can understand their full medical records. The alleged conversation took place at a private meeting for Cancer Moonshot, a program with which Biden has been associated since his son died of cancer.

According to a piece in Becker’s Health IT & CIO Review, Faulkner asked Biden why patients actually needed their full medical records. “Why do you want your medical records? They’re a thousand pages of which you understand 10,” she is said to have told Biden.

Epic responded to the widely-reported conversation with a statement arguing that Faulkner had been quoted out of context, and that the vendor supported patients’ rights to having their entire record. Given that Becker’s had the story third-hand (it drew on a Politico column which itself was based on the remarks of someone who had been present at the meeting) I have little difficulty believing that something was lost in translation.

Still, I am left wondering whether this piece had touched on something important nonetheless. It raises the question of whether EMR vendor CEOs have the attitude towards patient medical record access Faulkner is portrayed as having.

Yes, I suspect virtually every EMR vendor CEO agrees in principle that patients are entitled to access their complete records. Of course, the law recognizes this right as well. However, do they, personally, feel strongly about providing such access? Is making patient access to records easy a priority for them? My guess is “no” and “no.”

The truth is, EMR vendors — like every other business — deliver what their customers want. Their customers, providers, may talk a good game when it comes to patient record access, but only a few seem to have made improving access a central part of their culture. In my experience, at least, most do what medical records laws require and little else. It’s hard to imagine that vendors spend any energy trying to change customers’ records practices for the better.

Besides, both vendors and providers are used to thinking about medical record data as a proprietary asset. Even if they see the necessity of sharing this information, it probably rubs at least some the wrong way to ladle it out at minimal cost to patients.

Given all this background, it’s easy to understand why health IT editors jumped on the story. While she may have been misrepresented this time, it’s not hard to imagine the famously blunt Faulkner confronting Biden, especially if she thought he didn’t have a leg to stand on.

Even if she never spoke the words in question, or her comments were taken out of context, I have the feeling that at least some of her peers would’ve spoken them unashamedly, and if so, people need to call them out. If we’re going to achieve the ambitious goals we’ve set for value-based care, every player needs to be on board with empowering patients.

The EMR Vendor’s Dilemma

Posted on June 6, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Yesterday, I had a great conversation with an executive at one of the leading EMR vendors. During our conversation, she stressed that her company was focused on the future – not on shoring up its existing infrastructure, but rather, rebuilding its code into something “transformational.”

In describing her company’s next steps, she touched on many familiar bases, including population health, patient registries and mobile- first deployment to support clinicians. She told me that after several years of development, she felt her company was truly ready to take on operational challenges like delivering value-based care and conducting disease surveillance.

All that being said – with all due respect to the gracious exec with whom I spoke – I wouldn’t want to be a vendor trying to be transformed at the moment. As I see it, vendors who want to keep up with current EMR trends are stuck between a rock and a hard place.

On the one hand, such vendors need to support providers’ evolving health IT needs, which are changing rapidly as new models of care delivery are emerging. Not only do they need to provide the powerhouse infrastructure necessary to handle and route massive floods of data, they also need to help their customers reach and engage consumers in new ways.

To do so, however, they need to shoot at moving targets, or they won’t meet provider demand. Providers may not be sure what shape certain processes will take, but they still expect EMR vendors to keep up with their needs nonetheless. And that can certainly be tricky these days.

For example, while everybody is talking about population health management, as far as I know we still haven’t adopted a widely-accepted model for adopting it. Sure, people are arriving at many of the same conclusions about pop health, but their approach to rolling it out varies widely.  And that makes things very tough for vendors to create pop health technology.

And what about patient engagement solutions? At present, the tools providers use to engage patients with their care are all over the map, from portals to mobile apps to back-end systems using predictive analytics. Synchronizing and storing the data generated by these solutions is challenging enough. Figuring out what configuration of options actually produces results is even harder, and nobody, including the savviest EMR vendors, can be sure what the consensus model will be in the future.

Look, I’m aware that virtually all software vendors face this problem. It’s difficult as heck to decide when to lead the industry you serve and when to let the industry lead you. Straddling these two approaches successfully is what separates the men from the boys — or the girls from the women — and dictates who the winners and losers are in any technology market.

But arguably, health IT vendors face a particularly difficult challenge when it comes to keeping up with the times. There’s certainly few industries are in a greater state of flux, and that’s not likely to change anytime soon.

It will take some very fancy footwork to dance gracefully with providers. Within a few years, we’ll look back and know vendors adapted just enough.

Do Vendor Business Models Discourage EMR Innovation?

Posted on April 4, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Despite the ever-mounting levels of physician frustration, in some ways EMRs have changed little from their mass-market rollout. EMR interfaces are still counterintuitive, data sharing possibilities are limited, important information still lives in isolated silos and endless data entry is the rule rather than exception.

In theory, we could do better if we had a reasonable vision of what should come next. For example, I was intrigued by ideas proposed by Dr. Robert Rowley of Flow Health. He describes a model in which EMRs draw on a single, external data source which isn’t confined to any one organization. Providers would access, download and add data through a modern API.  Given such fluid access to data, providers would be able to create custom front-ends based on a collection of apps, rather than rely on a single vendor-created interface.

Unfortunately, EMR vendors are unlikely to take on a completely different approach like Rowley’s, for reasons inherent to their business model. After all, they have little reason to develop new, innovative EMRs which rely on a different data architecture. Not only that, the costs associated with developing and rolling out a completely new EMR model would probably be very high. And what company would take that chance when their existing “big iron” approach still sells?

Not only that, EMR vendors would risk alienating their customers if they stray too far off the ranch. While an innovative new platform might be attractive to some buyers, it might also be incompatible with their existing technology. And it would probably require both providers and vendors to reinvent workflows and transform their technical architecture.

Meanwhile, in addition to finding a way to pay for the technology, providers would have to figure out how to integrate their existing data into the new system, integrate the platform with its existing infrastructure, retrain the staff and clinicians and cope with reduced productivity for at least a year or two. And what would become of their big data analytics code? Their decision support modules? Even data entry could be a completely new game.

Smaller medical practices could be pushed into bankruptcy if they have to invest in yet another system. Large practices, hospitals and health systems might be able to afford the initial investment and systems integration, but the project would be long and painful. Unless they were extremely confident that it would pay off, they probably wouldn’t risk giving a revolutionary solution a try.

All that being said, there are forces in play which might push vendors to innovate more, and give providers a very strong incentive to try a new approach to patient data management. In particular, the need to improve care coordination and increase patient engagement – driven by the emergence of value-based care – is putting providers under intense pressure. If a new platform could measurably improve their odds of surviving this transition, they might be forced to adopt it.

Right now, providers who can afford to do so are buying freestanding care coordination and patient engagement tools, then integrating them into their existing EMRs. I can certainly see the benefit of doing so, as it brings important functions on board without throwing out the baby with the bathwater. And these organizations aren’t forced to rethink their fundamental technical strategy.

But the truth is, this model is unlikely to serve their needs over the long term. Because it relies on existing technology, welding new functions onto old, clinicians are still forced to grappled with kludgy technology. What’s more, these solutions add another layer to a very shaky pile of cards. And it’s hard to imagine that they’re going to support data interoperability, either.

Ultimately, the healthcare industry is going to be bogged down with short-term concerns until providers and vendors come together and develop a completely new approach to health data. To succeed at changing their health IT platform, they’ll have to rethink the very definition of key issues like ease of use and free data access, care coordination, patient engagement and improved documentation.

I believe that’s going to happen, at some point, perhaps when doctors storm the executive offices of their organization with torches and pitchforks. But I truly hope providers and vendors introduce more effective data management tools than today’s EMRs without getting to that point.

Encouraged By Political Changes, Groups Question ONC Functions

Posted on March 21, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Riding on an anti-regulation drive backed by the White House, groups unhappy with some actions by ONC are fighting to rein it in. President Trump has said that he would like to see two regulations killed for every new reg, and the groups seemingly see this as an opening.

One group challenging ONC activities is HealthIT Now, a coalition of providers, payers, employers and patient groups.

In a letter to HHS Secretary Tom Price, Health IT Now argues that ONC exceeded its authority last year, when it backed an oversight rule designed to boost the certification process by evaluating vendor interoperability capabilities.

The 2016 rule also holds health IT vendors accountable for technology flaws that could compromise patient safety, an approach which, HITN argues, steals a move from federal agencies such as the FDA. The group also contends that ONC has not been clear about its criteria for critiquing HIT solutions for safety problems.

Meanwhile, a group of medical societies and specialties is asking federal health officials to hold off on 2015 EHR certification requirements, which providers are expected to start using January 2018, for at least one year. The group notes that since ONC released its final 2015 Edition requirements, few vendors – in fact, just 54 of 3,700 products currently certified – have fully upgraded their systems.

Given this situation, rushing to deploy the latest certification requirements could create big problems, including a major disruption to medical practices’ business, the coalition argues.

If they’re forced to choose from the small number of systems which have upgraded their platforms, “physicians may be driven to switch vendors and utilize a system that is not suitable for their specialty or patient population,” the group said in a letter to CMS acting administrator Patrick Conway, MD, and acting ONC national coordinator Jon White, MD.

In addition to addressing certification concerns, there’s much the federal government can do to support health IT improvement, according to attendees at HIMSS17.

According to HITN, attendees would like policymakers to address interoperability, in part by reviewing Meaningful Use and the ONC Voluntary Certification programs; to focus on improving patient identification systems, and avoid imposing barriers to private market solutions; to clarify the role of the ONC in the marketplace; and to encourage the use of real-world evidence in healthcare and health IT deployment.

As I see it, these ideas veer between close-in detail and broad policy prescriptions, neither of which seem likely to have a big effect on their own.

On the one hand, while it might help to clarify ONC’s role, authority and process, the truth is that the health IT market isn’t living or dying on what it does. This is particularly the case given its revolving door leaders with too little time to do more than nudge the industry.

Meanwhile, it seems equally unlikely that the federal government will come up with generally-applicable policy prescriptions which can solve nasty problems like achieving health data interoperability and sorting out patient matching issues.

I’m not saying that government has no role in supporting the emergence of health IT solutions. In fact, I’m fairly confident that we won’t get anywhere without its assistance. However, until we have a more effective role for its involvement, government efforts aren’t likely to bear much fruit.

Physicians Still Struggle To Find EHR Value

Posted on July 18, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study by Physicians Practice magazine suggests that medical groups still aren’t getting what they want out of their EHRs, with nearly one-fifth reporting that they’re still struggling with an EHR-related drop in productivity and others still trying to optimize their system.

Physicians Practice surveyed 1,568 physicians, advanced practice providers across the U.S. as part of its 2016 Technology Survey. Nearly a third of respondents (31.9%) were in solo practice, and 34% in 2 to 5 physician practices, with percentages largely dropping as practice sizes grew larger.

Specialties represented included pediatrics (17.5%), family medicine (16.2%), OB/GYN (15.2%), psychiatry (12%), internal medicine (10.6%), surgery (2.9%), general practice (2.7%) and “other” at 22.9% (led by ophthalmology). As to business models, 63.3% of practices were independently-owned, 27.9% were part of an integrated delivery network and the remaining 8.8% were “other,” led by federally-qualified health centers.

Here’s some interesting data points from the survey, with my take:

  • Almost 40% of EHR users are struggling to get value out of their system: When asked what their most pressing technology problem was, 20.3% said it was optimizing use of their EHR, 18.9% a drop in productivity due to their EHR, and 12.9% a lack of interoperability between EHRs. Both EHR implementation and costs to implement and use technologies came in at 8%.
  • EHR rollouts are maturing, but many practices are lagging: About 59% of respondents had a fully-implemented EHR in place, with 14.5% using a system provided by a hospital or corporate parent. But 16.8% didn’t have an EHR, and 9.5% had selected an EHR (or a corporate parent had done so for them) but hadn’t fully implemented or optimized yet.
  • Many practices that skip EHRs don’t think they’re worth the trouble and expense: Almost 41% of respondents who don’t have a system in place said that they don’t believe it would improve patient care, 24.4% said that such systems are too expensive. A small but meaningful subset of the non-users (6.6%) said they’d “heard too many horror stories.”
  • Medical group EHR implementations are fairly slow, with more than one-quarter limping on for over a year: More than a third (37.2%) of practices reported that full implementation and training took up to six months, 21.2% said it took more than six months and less than a year, 12.8% said more than a year but less than 18 months, and 15.7% at more than 18 months.
  • Most practices haven’t seen a penny of return on their EHR investment: While just about one-quarter of respondents (25.7%) reported that they’d gotten ROI from their system, almost three-quarters (74.3%) said they had not.
  • Loyalty to EHR vendors is lukewarm at best: When asked how they felt about their EHR vendor, 39.7% said they were satisfied and would recommend them, but felt other vendors would be just as good. Just over 16% said they were very satisfied. Meanwhile, more than 17% were either dissatisfied and regretted their purchase or ready to switch to another system.
  • The big EHR switchout isn’t just for hospitals: While 62.1% of respondents said that the EHR they had in place was their first, 27.1% were on their second system, and 10.8% their third or more.

If you want to learn more, I recommend the report highly (click here to get it). But it doesn’t take a weatherman to see which way these winds are blowing. Clearly, many practices still need a hand in getting something worthwhile from their EHR, and I hope they get it.

The Case For Dumping EMR Interoperability Goals

Posted on December 22, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The new year is upon us, and maybe we should consider some new approaches, or even throw out accepted wisdom. Why not consider some major pain points and reconsider how we’re handling them?

In that spirit, my question is this: Should we give up on the idea that EMR vendors will ever allow their data will be interoperable? While this conclusion isn’t exactly a no-brainer, many of us have certainly toyed with the idea. So let’s take ‘er out for a spin.

One major consideration is that EMR vendors have some very compelling reasons for keeping things as they are. Perhaps most notably, interoperability would mean that providers wouldn’t be trapped in deals with a single vendor, as they could just shift the data over to a new platform if the need arose. If I sold EMRs I’d fight tooth and nail to prevent my product from being dumped too easily.

As if that weren’t enough of a disincentive, EMR vendors would need to spend big bucks to achieve interoperability, with no direct reward in sight. Somehow, I doubt that they’re ever going to make such an investment to win some “nice guy” award from the industry.

And even if they could somehow achieve interoperability without breaking a sweat, we’ve got to contend with inertia. Making changes on that scale takes a great deal of effort, and EMR vendors have very little reason to do so.

Maybe the federal government could achieve interoperability through some kind of epic power play, like refusing to issue Medicare reimbursement to providers whose EMRs didn’t meet some ONC interoperability standard.

But even that kind of brute force wouldn’t solve the interoperability problem with one stroke. Such an approach would come with a raft of serious concerns. What interoperability standard would ONC use, and how long would it take to choose? Then, how long would vendors have to meet the standard?  How long would providers have to decommission their existing EMR — and let’s not forget, quite possibly interlocking HIT systems — and where would they get the money for the new/upgraded systems?

Not only that, it would it cost billions of dollars, without a doubt, to make this transition. It could take a decade before the transition was complete. A lot can happen to derail such an initiative over that amount of time, and market forces could render the premises of such an effort obsolete.

On top of that, any effort which encouraged providers to dump their existing EMR platform would greatly diminish, if not erase, the value of the billions of dollars invested in Meaningful Use incentives. A lot of effort has gone into workflow and interface designs that support MU compliance, and starting from scratch on a new platform would NOT be a walk in the park.  So meeting MU goals might be possible over time, but could fall by the wayside for the short term.

All told, it seems that we may be chasing our tails trying to push through interoperability. In theory it sounds good, but when you look at the details it seems unlikely to happen. That being said, the need to share patient data isn’t going to go away, so what alternatives might work? I’ll follow up with some additional thoughts.

A Lawyer’s Perspective on EHR Vendors Holding EHR Data Hostage

Posted on October 23, 2015 I Written By

The following is a guest blog post by Bill O’Toole is the founder of O’Toole Law Group.
William O'Toole - Healthcare IT and EHR Contracts
The recent post, EHR Data Hostage Wouldn’t Exist if EHR Were Truly Interoperable, on EMR & HIPAA got me thinking, and I wanted to offer a few observations from my experience as an HIT lawyer.

The goal is wonderful. However, it would take years and years to achieve such a goal. Data extraction and subsequent import take time, sometimes lots of it. What if there were a standardized specification to which vendors could design extraction tools and programs? Follow that with contractual commitment that the vendor adheres to those specifications. We did it with HL-7, why not data transport?

Thankfully I have not yet represented a vendor that withheld data solely due to the departure of a customer. I have however been involved in very tough situations where the vendor treads a fine line in not releasing data until customers fulfill their obligations (such as paying for use of the software). I like to believe that there is more to the story in the vast majority of data hostage disputes, and in my experience, this has always been the case.

The emergence of the hosted subscription model has resulted in a control shift to the vendor, as opposed to the on premises model where the customer is in control and a vendor can be shut out. That said, vendor assistance is usually required to extract data.

“HIPAA vs. vendor rights” is a very hot topic for me. Providers must provide patient data on request. Vendors have a right to be paid. The contractual right of a vendor to suspend customer access to a hosted EHR butts head-on against HIPAA. I have discussed this with ONC and while the problem is recognized, there is no solution at the present time.

Bill O’Toole is the founder of O’Toole Law Group of Duxbury, MA. You may contact him at wfo@otoolelawgroup.com

If EHR Had a Tech Problem We’d Blame the Vendors

Posted on July 23, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

During last week’s #KareoChat, the chat host @GabrielSPerna offered the following tweets from the @PhysiciansPract account for which he is now managing editor (Gabriel Perna was formerly @HCInformatics):

When I saw this tweet, I knew I needed some time to chew on the concept. Do we really blame our vendor when it’s a tech problem? I’m reminded of a time my EHR software ran out of control and was literally chewing up RAM and never spitting it out. I’d restart the server and we’d be fine until the EHR software had chewed up all the RAM again and then the EHR was slow as molasses. You can bet I was blaming my EHR vendor for the tech problems we were having.

However, did I blame them for our cultural challenges as well? I guess the key term there for me is “blame.” I know many practices (and have heard of others) who have switched EHR vendors 3, 4, even 5 times. They loved to blame the previous EHR vendors for their problems. However, by the 2nd or third, you can be sure there are some cultural problems there that need to be resolved. As much as they want to blame the EHR vendor they’re likely not to blame.

Another tweet from today’s #KareoChat seems to also illustrate the challenge is cultural and not technical:

I can already hear Dr. Tom in his EHR product management meetings asking why they’re building a certain feature into the software when it supports a flawed process. The developers respond that it’s what the customer wants. This highlights a major cultural problem.

Back to the original discussion. The fact that many doctors haven’t seen an ROI from their EHR, but less than 20% are dissatisfied with their EHR vendor does seem to say that most EHR vendors have not had tech issues. Instead the EHR dissatisfaction likely stems from a lot of other cultural problems in healthcare.

All of this reminds me of some old posts where I asked “Can An EMR Focus on Patient Care in the Current Reimbursement Environment?” and what would an EHR look like if it was focused on customer requests and not MU? Is the healthcare culture what has created these less than happy EHR users or is that letting the EHR vendors off the hook?

The Same EHR “Chain of Events”

Posted on December 31, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently came across this interesting perspective on the EHR industry on the MGMA blog. Here’s one of the perspectives shared on the blog post:

Miske said his practice’s previous eight EHR selections have followed the “same chain of events”:
*Heavy research, tons of demos
*Implementation
*Training and research
*Relentless tweaking
*Stagnant use
*Systematic bugs reveal themselves
*Issues become unreasonable
*Tech support starts to lack

For his practice’s ninth EHR, Miske refused to settle for inferior quality or employing counterintuitive fixes, such as saying, “let’s hire more people to deal with the inadequacy of the program.”

“Being of the technological mindset that I am, this is unfathomable – the EHR/PM system needs to be a tool and a wonderful tool. Just like our ultrasound machine that allows us to perform 4D miracles without issue daily,” he says.

I have to start by addressing that the above comments are by someone who has done 8 EHR selections. Sure, that means they’ve had a lot of experience with EHR implementations, but from my experience it also likely indicates an internal issue that all 300 EHR vendors would likely face with that practice.

I was recently talking to an EHR implementation manager at an EHR company. They recounted to me how their sales people would bring them a new sale and comment that “this EHR implementation should be easy since they’ve already had 3 EHRs previously.” He then commented that those always end up being the worst implementations since there’s likely some organization problem that needs to be fixed before doing the EHR implementation. Certainly having some understanding of how EHR and software work helps during an EHR implementation, but so many failed EHR implementations often means that something else is at play beyond the EHR.

Personally, I haven’t seen the chain of events that he describes. I’ve seen certain pieces of what he describes, but not all EHR implementations follow that pattern. The last 3 items on the list are things I’ve seen a lot of places with a bunch of EHR vendors.

Bugs are a reality of software use. The key is how the EHR vendor reacts to your bug reports. That will make all the difference in your organization. This is why I’ve said many times that you should cultivate a close connection to your EHR vendor. When you find and report these bugs, having a good relationship with your EHR vendor will be critical to make sure your report is heard.

In the beginning of your EHR implementation, you’re likely to get special attention. So, take the time early to really figure out any pain points the software is causing you. You’ll likely get a quick response. As you become a long time user, you’ll have to rely on a deeper relationship.

If all else fails, remember that the squeaky wheel gets greased. Be careful not to ruin your relationship, but there are a lot of ways to get your concerns heard and addressed. Don’t be shy if a change really matters to you and your organization.

What Would You Do If your EHR Vendor Shut Off Access to Your EHR?

Posted on September 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Anne Zieger at Healthcare Dive has an interesting summary of a practice who just had their EHR access shutdown by an EHR vendor. Here’s the summary of what happened:

*A small medical practice in northern Maine has been blocked from accessing patient medical records because its EMR vendor has shut them off.
*Vendor CompuGroup says the practice, Full Circle Health Care, won’t get access to its records back until it pays $20,000 in overdue charges to the vendor.
*The medical group acknowledges that it stopped paying CompuGroup $2,000 per month in monthly fees 10 months before the July shut off, but said that was after months of attempting to address what the practice considered to be exorbitant, unexpected maintenance fees and charges for hardware that didn’t arrive.

This is a really challenging situation. No doubt the vendor wants to make sure it gets paid and needs some sort of recourse. Although, if you’ve ever had an EHR on which you relied, you know how important it can be to the care you provide. Just ask anyone who has had their EHR go down. Unless you have great EHR downtime procedures it can get a little crazy. Now just imagine that your EHR was taken down with no sign of when it will be back up.

Of course, we’re a little short on the exact details of what happened with Full Circle Health Care and CompuGroup. I’d love to know how many warnings CompuGroup gave Full Circle Health Care before they turned it off. If they gave them the right number of warnings over a certain period, then I don’t begrudge them for making the decision they made. If they just pulled the plug without very specific warnings about what was going to happen, then CompuGroup should get some of the blame.

This would make for an interesting court case. I imagine there’s previous case law from other industries that would illustrate what would happen. Although, in healthcare we’re not just talking about lost business and financial impact. Turning off someone’s EHR could literally kill someone. That’s pretty scary to consider.

I’m surprised that CompuGroup hasn’t gotten ahead of the story. That’s what I’d want to do if I were in their shoes. Unless the facts don’t put CompuGroup in a very nice light. However, it’s hard to put them in a worse light than they already are in with the story above.

Do you think it’s ok for an EHR vendor to turn off someone’s EHR if they stop paying? Should there be laws that say that an EHR vendor can’t do that? What would you do if you were in this practice’s situation?

For me this is really hard to think about, because if I were at that practice I would never let it get to this point. I’ve heard of a few cases where EHR vendors have become a black hole of unresponsiveness. However, that’s really rare and usually only happens when other really major and scarier things are happening at the company.