EHR Vendors on Meaningful Use: Enough is Enough!

EHR Vendors on Meaningful Use: Enough is Enough!Physicians, professional societies, and EHR vendors are now aligned against the complexity and pace of the meaningful use program. In my last two EMR Straight Talk posts, I shared my concerns about the future of the meaningful use program. My letter to Farzad Mostashari relayed the rampant dissatisfaction expressed by physicians about the program’s complexity, the government’s unrealistic expectations, and the impact on physician productivity. In my last post, Physicians Are Crying “Uncle!”, I discussed how physicians and the professional societies that represent them are demanding that the runaway meaningful use train be slowed. Of paramount concern to physicians is the fact that the EHR usability they crave is being sacrificed in the pursuit of certification.

EHR vendors collectively expressed their concerns in a comment letter from the HIMSS EHRA (Electronic Health Record Association) to the HIT Policy Committee about the initial proposal for Stage 3, and their message was in synch with that of the physicians and their societies. The vendors focused on the government’s interference with their ability to innovate, and they expressed their frustration over being unable to creatively address the needs and demands of physicians for new capabilities:

The needs of such experienced and often sophisticated [physician] users will best be met by market innovation, while extensive and detailed standardized requirements dictated by the federal government are not only unnecessary but may actually interfere with the pace and direction of needed innovations.

Vendors advocate, as I do, for the government to limit its focus to overarching issues like ensuring interoperability, and they argue against the government simply piling on more new measures. The opportunity to innovate is being thwarted by government programs that force vendors to devote all available resources to an ongoing chase after continually changing certification requirements.

Rarely do we see such close alignment between physicians and vendors on any matter. If CMS and ONC continue plowing ahead, ignoring the pleas of these major stakeholders, history will deem them to have been woefully negligent stewards of a program that started out with such laudable goals.

7 Responses to “EHR Vendors on Meaningful Use: Enough is Enough!”

  1. Nancy Neighbors, MD February 8, 2013

    You made an excellent point. Everyone dislikes bad software. Write better software and you will get fewer complaints. No one had to sign up for meaningful use unless they had an opportunity to buy something of value. I fully support requiring a two year period in which vendors are required to refund all cost spent on crappy software, hardware, training, etc. and for physicians to return their MU incentive to the Government. Ten percent of us appear to very happy with our EMRs. Looks like the other 90% failed by buying in to early.

  2. J F Barakeh February 8, 2013

    As I noted in a reply I wrote to Dr. Mostashari’s discussion, what you and I and even vendors want is irrelevant to CMS and ONC. The mandate for EHR exists not to improve patient outcomes or ease of physician use; it exists to oversee and control health care. The pace of US physicians recognition of this fact is too slow to rescue the profession of medicine, as more and more doctors abdicate their authority to third parties. The bodies upon which we have relied for leadership, e.g. the AMA, have been bought out by the same mechanism which has carved out Big Pharma and trial lawyers from the onerous cost saving of Obamacare. If no one adopts EHR, CMS still wins by penalty discounted payments to us. Please consider this the next time you attend your state or US professional meetings. Get a dialog going, please.

  3. As an non-medical provider (I have financial degrees) I am stunned by the level of bullying that the provider community has gone through. I worked in NYC in the financial district and now closely manage a specialty provider for the past 13 years. The government wants complete authority and no responsibility over the physician duties. The vendors do not have the product that the government wants (e.g., would be templating is the best product that the EMR vendors have right now.). Yet providers are pushed around and found fault with everything that they do – i.e., penalties for “cloning” which is nothing but EMR template documentation or their medical abbreviations that now the providers have to write in basic terminologies (which is unheard of in the engineering or financial districts.), or pay penalties to the US government if they do not incorporate faulty EMR technologies. Then, the worse part is through ACOs, government is going to penalize doctors for not working ehm….50 hours a day because with the way the ACOs are set up “coverage” does not mean “access” and the government will ding the overbooked providers for not doing “timely” medical treatments… and now let’s not forget the “innocent” bystanders – i.e., the patients who get ALL kind of rights from all kinds of governmental regulations BUT NO accountability and responsibilities for their health maintenance and care.

    The government gets what it wants: TOTAL control over what the MD does.
    United HealthCare already has gotten the contract from the Government: So they are covered.
    The citizens get free everything at ALL times and whenever they want. The Vendors like the new market and try to make a go at it and when things fail the provider is dinged.

    So In the end no one cares about the provider providing care who have literally given up his or her life trying to be an MD in the first place. He has no rights but only government mandated professional slavery.

    No wonder we will be seeing a shortage soon in the medical profession. This kind of bullying should stop. Policing is important. But that does not mean the government and all its allies should bite the hand that heals. It is going to end up with no hands or feet to move or treat its citizens.

  4. For 8 years I have been using a non-certified EMR that has been discontinued and for the last 1-2 years is no longer supported. It works great and has much better functionality that all of the new programs that have popped up to take advantage of the MU mandates. When I ask the vendors why that can’t develop their program to be as good as a program that started about 15 years ago, they all say the same thing – government regs and MU requirements. As I am not interested in MU, this has made the search for a new EMR very disappointing.

    What is the solution? Drop Medicare, then drop Medicaid and 3rd party insurance plans. Charge reasonable fees, and forget the regulations, penalties, etc. Govt and insurers have no control over providers who do not participate. The provider is free to provide medical care. Vendors will see this as a niche for which to develop a good functional product.

    Let’s all agree to adopt this starting Jan. 2014. I can dream can’t I?

  5. Michael Butcher,MD. February 8, 2013

    This is the tip of the iceberg; wait til Affordable HealthCare gets started; who will be the providers and at what reimbursable rate; any information on this? Send your concerns to President Obama and ask for response on status of EHR.

  6. mike messieh February 14, 2013

    In my opinion embracing MU is the right strategy using cost benefit metrics

  7. Doctors need to go on strike i.e. every other month on Wednesday at 12 noon in front of their
    respective state capitals. Doctors will only treat that day acute care patients.
    Doctors will ask for the following:

    1. No further progression of meaningful use beyond stage 1.

    2. Insurance companies will pay the doctors the deductible portion of patients’ E.O.B.s and then the insurance company will bill the deductible to the patient at the next premium statement.

    Doctors need to pass out literature to patients explaining our issues and ask for their support and join us in front of the state houses of each of the 50 states.

    Let us begin in March, 2014.

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