The EHR incentive equation is often presented quite simply:
The truth is that there are variations in all elements of this equation. A certified EHR is more than an ONC stamp of approval. Certification indicates that a product meets standards, but doesn’t indicate how the product is implemented, used, or supported. Meaningful Use is intricately related to the certified EHR and its features. Ultimately, the combination of these two elements determines if a provider receives his or her incentive payment.
Yesterday I wrapped up an exciting three days in Orlando at the 2011 HIMSS Conference. The event attracted about 30k people from the HIT world and, after three days, it seemed as though I talked with nearly every one of the attendees and exhibitors. My feet hurt, my voice is a bit raspy, and I’m certainly tired, but the conference experience was very worthwhile. There is such positivity surrounding Practice Fusion that I can’t help but feel inspired and fully charged by our goal of ensuring that all providers have access to a superior quality EHR. It further strengthened my resolve to help Practice Fusion users achieve Meaningful Use.
I was particularly excited to chat with six EHR vendors to understand how they view certification, what meaningful use means to them, and how they would support their providers who are so anxiously looking to receive their incentive payments. Below are some of my thoughts about other vendors’ strategies.
Certification and Meaningful Use
Nearly every vendor with whom I spoke considered certification a low hurdle to surpass. Many of these vendors had achieved certification within a few months of guidelines being published. My suspicion is that their goal was to meet criteria requirements as quickly as possible to boost their marketing efforts. This translated into certification achievement without delicately mapping criteria to physician needs and workflows. Watching vendor demos, I found myself lost in the many sub-menus that users will have to navigate in order to meeting many meaningful use criteria, the upgrade requirements, and the many hours of costly training and support that providers will need to undergo to be prepared to use the certified version of the EHR.
One key feature that was lacking was a simple, intuitive means by which to track and understand providers’ progress in achieving Meaningful Use. When asked about this functionality, vendors replied in one of three ways: they didn’t know how this information would be tracked, providers could print a report, or they had created a dashboard.
I was only able to see one report and one dashboard. They were difficult to use, highly complex, and not easily accessed. Providers will need to feel supported in attesting Meaningful Use and these vendors severely missed the mark in an effort to achieve certification status as quickly as possible.
Support is the other key piece to the certification portion of the equation. One vendor with whom I spoke fully admitted that providers would need significant training to use the certified version of their product and that live support is not free or immediately available. Based on my talks with other vendors and conference participants, I think that this is likely true for many EHR vendors.
Design of the certified product, tools to easily track meaningful use, and support availability all affect a provider’s ability to achieve Meaningful Use. Nevertheless, we operate in an environment where the belief is that all certified products are created equal.
Every provider will have a unique experience with his or her EHR. The winners will be those that are using products that paid special attention to the certification process, Meaningful Use criteria, and are supporting their users along the way.
Conclusion
The revised equation is significantly more cumbersome and is reflective of the careful consideration that the product development process requires. I won’t attempt to describe it with variables, powers, numbers, or parenthesis, but we will be able to reflect in the next near on its results: incentive payments for providers.
Jumping into the deep end with six major players in the EHR space simply confirmed my suspicion that the product significantly impacts a provider’s ability to receive incentive payments and that a carefully designed product will be the difference between incentive payment and frustration, overtime, and high costs.
Thomas McMennamin
Health Policy Manager
Practice Fusion EHR
