In the rush to cash in on the thousands of physicians adopting electronic health record (EHR) systems, as many as 300 EHR companies have launched since 2010, according to one industry consultant, bringing the total number of vendors up to more than 600.
This activity is not surprising considering that physicians who achieved Meaningful Use of EHRs in the Centers for Medicare and Medicaid Services (CMS) program are eligible for $44,000 over five years. Since the program was announced, however, many physicians fell prey to the promises of these EHR vendors, some of whom have since been acquired or gone out of business. These vendor promises were primarily focused on physicians being able to attest for Meaningful Use and meet patient engagement requirements, but some companies also assured practices that physicians would quickly adopt these systems because they were so easy to use and could easily integrate into practice workflows.
In the aftermath, practices and physicians were stuck with expensive, inefficient software that was designed by programmers, not physicians. The software destroyed productivity and alienated patients in the exam room since physicians interacted more with their computer than with them.
With the advantage of hindsight, physicians won’t be burned again by EHR systems that slow them down, interfere with patient care and don’t support established workflows. Physicians in the market today will find highly usable, cloud-based, SaaS systems that don’t require huge upfront hardware and server investments, long-term contracts, or weeks of costly provider training. Companies now are offering systems with affordable fees in the low hundreds per month and month-to-month agreements.
Physicians looking to avoid falling prey to EHR vendor promises should answer the following three questions when investigating and deciding on a new system.
Will physicians adopt? Insist that all the physicians in your practice test the system to determine if it supports their workflow. For example, does the software allow them to chart and create progress notes with the method they prefer, such as typing, dictating or writing by hand? Ensure that the user interface is familiar to physicians so they won’t be slowed down searching for the forms and fields they want to complete.
Does it support your specialty? Even today, the design of many EHR systems tend to favor the primary care specialties such as family medicine, pediatrics and general internal medicine. While there is certainly documentation overlap between specialties, your practice’s EHR system should support the unique charting and imaging needs of the body area and conditions of your specialty. Don’t fall for the vendor’s promises that the software can be customized for your specialty at a later date—see it in operation now.
Will it facilitate data exchange? Meaningful Use stages 2 and 3 contain electronic data exchange requirements. Although the requirements were reduced somewhat between the Stage 2 proposed rule and the final rule, physicians must still “either conduct an electronic exchange of summary of care documents with an EHR system that is different from its own, demonstrating interoperability, or conduct one or more successful tests with CMS’ designated test EHR through the EHR reporting period,” according to the Health Information and Management Systems Society. Stage 3 data exchange requirements will certainly be more demanding. Practices should see proof, not promises, that their new EHR software will meet these requirements. Not only will physicians be able to attest for Meaningful Use, but also the electronic data exchange will support improved care coordination and safer clinical decision-making.
Hopefully, the second time around, with a few questions for the vendor, physicians will find an EHR system that will fulfill all the promises made by the salespeople from their first system.