As most of you have probably figured out by now, I’m not really a fan of EHR certification because I believe there is very little value provided by EHR certification. An interesting additional problem that comes from EHR certification and meaningful use has to do with how EHR vendors are using this as an excuse for why their EHR sucks doesn’t work the way doctors want it to work.
Don’t just think that I’m making this idea up. I first thought about this idea when a doctor wrote me about his experience with an EHR vendor that used EHR certification as an excuse for why their EHR software’s workflow was terrible.
The interaction went something like this:
Doctor: Why do I have to do these extra 5 clicks?
EHR Vendor: That’s required by EHR certification.
Doctor: That provides no value to the care I provide a patient.
EHR Vendor: Sorry, we have to do that for EHR certification.
Doctor: What about this other prompt I get in your EHR? Why does that come up and disrupt my workflow?
EHR Vendor: That’s another EHR certification and meaningful use requirement.
You’ll notice that I made the complaints generic, because they likely could apply to almost any measure in meaningful use and EHR certification requirement.
I’ve seen first hand the efforts that some EHR vendors have put forward to try and make sure that their doctors don’t have this discussion with them. You can be sure it takes a lot of time, energy, and skilled professionals to make meaningful use and EHR certification a seamless part of a practitioner’s EHR experience.
The problem is that many many EHR vendors just ran the EHR certification race and in an attempt to win that race they just slapped something together to meet the requirements. This I want to be the “first” EHR vendor certified mentality is causing many doctors to pay the price today.
Is it any wonder that many doctors look at meaningful use and are upset by the way it’s changing the way they practice medicine?
Anonymous for obvious reasons..
Long story short: the vendor I work for made a strategic decision, one that has cost us business and personally but we believe might be best for our customers in the long term. And we really do care – our customer’s livelihoods (and ours) depend on it.
That decision was not to pursue EHR certification at all.
It was a hard decision, requiring a lot of analysis and handwringing, and it took almost as long to decide it as it might have to “slap something together”.
The customers who stayed with us (and there are some big ones) agree with this position. Luckily, they do not have to suffer the penalty of a fine due to the industry sector they serve. They lost out on the incentives even though they support the intention of the EHR program, but they did not support or believe in the enforced mechanism.
The caveat is, that we as a vendor WILL implement any of the certification criteria that is deemed to make sense or be needed by the customer (a decision that is made between both parties). We are guaranteeing that we will be interoperable with any standards based exchange (or even non-standards based) that is required to work with other systems.
Is this the right attitude? We’re still not sure, but we have been in electronic medical records/health records business for a long time before the “EHR fad” started. We work really hard to understand what our customers want/need, and we don’t have the resources (and neither do they) to spend money and time on something they don’t need/want.
Interestingly, some customers who bought into the fad and ran out to buy an EHR did not realize that it was only a portion of the system they needed for their specialty. Some of them are stuck now half into an EHR that doesn’t do what they need, and half stuck in our software which does, and we are bearing the burden for them by helping them with interoperability between the two. This is a burden that costs us and doesn’t benefit us – but it falls under our guarantee – we will interoperate with any system that we have to.
Thanks for sharing the story. I think there are a few EHR vendors that have taken a similar approach, but not very many. I’ll definitely be interested to see how that shakes out. I think there’s a few specialty specific EHR that could use this strategy and still do well. Time will tell. At least you don’t have the problems and challenges I describe in my post above.
Interesting take. I also believe that hospitals use certification as an excuse as well to eliminate vendors fro the get-go who have not achieved certification. Not having appropriately weighed the pros and cons of what is required. Also Stage 2 is so watered down, it doesn’t really achieve the initial intention of the legislative action.
I went through EHR certification for a EHR product – for the sake of this discussion it can remain nameless as you can insert any EHR name and it will share the same issues. The process was cumbersome and I agree is not worthwhile for our clients. However at least 90% of our clients were requesting it and all of our sales pipelines say they required it. The interaction you describe I have had. I don’t think it’s the fault of us as a vendor as much as the short sightedness of the committee that created the certification rules. We had to implement fields/screens/buttons that served no purpose in the type of practice we supplied our software to. That did not matter to the certification proctor, we had to show it or we failed and lost a lot of money. Getting certified threw off our development cycle at least 6 months. During that time we had to push off many good customer requested enhancements. In hindsight would our customers prefer we did not get certified – probably, but could our company take a chance at not being able to renew contracts or get new sales. No way, not for a government mandated push.
Thanks for sharing Jeff. A very thoughtful comment that is a spot on analysis of the EHR market today when it comes to EHR certification.