Is the version of your EHR the Certified one?

Is the Electronic Health Record (EHR) system you are using in your practice the Certified version? Physicians who have invested in EHR systems already are now realizing the impact of this question.

EHR systems that are locally installed will all have the “version” issue. To pick an example, let’s look at one leading EHR vendor – Allscripts. Though hard to get a good handle on specific numbers, anecdotal reports indicate that their versions 8.x are the most common versions in use in the field. Given that money is involved in upgrading from a current installation to a newer one, some individuals report they are as much as “4 versions behind” in their Allscripts installation.

The Certified versions of Allscripts are version 9 for Allscripts MyWay, a Complete EHR which requires email software and spreadsheet software in order to meet all the Complete EHR qualifications; the Allscripts Enterprise Certified version is 11.2, and requires numerous other software pieces to be installed in order to achieve Complete EHR functionality (Microsoft Excel, Intuit Medfusion/Allscripts Patient Portal v10.6, Team Praxis/Allscripts Clinical Solution v3.2).

Users of these products need to see what it will take in order to upgrade to the Certified version and thus be able to access Meaningful Use money. Remember that use of Certified EHR technology is a sine qua non for access to any Meaningful Use bonus money from CMS.

Is there lag time in getting product upgrades? Can this be achieved in time to demonstrate 90 days of continuous use of a Certified EHR product during 2011?

Some reports have shows significant bottlenecks in upgrading, largely because of new demands on vendors who may struggle to locally upgrade their entire installation base. This has been the experience from the REC perspective, acting as “feet on the street” in doctor’s practices, helping install and become proficient in their chosen EHR. Further, the upgrades have shown evidence of bugs – e.g mis-counting e-prescribing denominators (failing to exclude prescriptions for controlled substances, which are excluded from the measure).

At the Q4 2010 Earnings Call, Allscripts’ CEO described their implementation backlog thusly: “…this is a market that is still largely defined by Enterprise-sized transactions. We are seeing positive momentum on the lower-end of the market, but what really constitutes our backlog today, you ought to be thinking about takedown over literally, several months, i.e. talked to the market about typically, nine-to-12, sometimes up to 18 months takedown.”

This is a source of increasing anxiety from physician practices, especially small to mid-size practices, that are relying on their EHR vendors to upgrade their versions to the Certified one – nine to 12 months, sometimes up to 18 months?

Is there an alternative?
Nowhere is there a better example of the benefits of a web-based EHR deployment over locally-installed and Enterprise solutions. A web-based EHR, such as Practice Fusion, puts into play the most current version of its software. As new features are added, and as successive Certification steps are taken, the most-current, Certified version is immediately available to all users everywhere. With a web application, there is no issue about “version” – you have the latest version at all times.

In addition, no vendor representatives are needed to install any new versions. Hence – no backlog. No waiting “9-12 months, sometimes up to 18 months” to be using the version that is needed for demonstrating Meaningful Use for 90 consecutive days in 2011.

Further, with self-service sign-up – simply go to the web site and Sign Up – the time to implementation is same-day. No need to wait for vendor representatives to schedule an appointment with your office and set you up – you set yourself up, learn the product on-line or in-product (with embedded videos throughout). And if you really need help with workflow adaptation in order to effectively make the change and begin using the EHR in your daily practice, there is a national network of Certified Consultants to help (for a nominal fee).

Robert Rowley, MD
Chief Medical Officer
Practice Fusion EMR