At the HIMSS10 annual conference in Atlanta, electronic health record vendors began ratcheting up the hype on what they called an EHR meaningful use "guarantee." This means that, if a practice buys and installs an EHR system, the vendor will guarantee that it will be meaningful use certified in time to reap financial incentives under the Health Information Technology for Economic and Clinical Health (HITECH) Act.
Vendors are making these guarantees as a way of showing providers that they, too, are invested in meaningful use compliance despite the fact they're not getting incentive dollars from the HITECH Act, wrote Gartner Inc. Vice President and Distinguished Analyst Wes Rishel in his report, "The Limits of Certification and Guarantees in Buying Electronic Health Records in the U.S."
What good are these guarantees, however, considering that vendors continue to make these promises at a time when the Office of the National Coordinator (ONC) for Health Information Technology has finished neither the meaningful use rules nor the certification process? Not much, Rishel wrote, because every vendor should make that promise to begin with -- and that saps a lot of the competitive advantage of guaranteed EHR meaningful use certification.
"If [practices] are running across vendors that are not willing to guarantee they are going to be certified, they should really, really understand why they would consider using that vendor," Rishel said in an interview with SearchHealthIT.com. "Certification is a relatively easy activity. You don't have to be that good to be certified. … If [a vendor] fails to get certified, they won't make any sales."
In both the report and interview, Rishel -- who also is a trustee of the Certification Commission for Health Information Technology (CCHIT), and a member of ONC's Health IT Standards Committee -- offered ten tips for physicians and health care IT leaders who must achieve EHR meaningful use, either by switching vendors or starting from scratch:
1. Rather than take the fastest route to EHR implementation, choose a system that is an excellent fit for your office, even if selection and installation take so long that you miss the first year's incentive payment. The costs of an ill-conceived, hastily made purchasing decision likely will far exceed the $11,000 worth of incentive money that a more reasoned decision might cost.
2. Look closely at the guarantee -- and factor what you find out into your decision -- to see whether the vendor will guarantee that software upgrades or future versions also will comply with current and future iterations of EHR meaningful use criteria.
3. Seek third-party certifications for meeting EHR meaningful use, such as CCHIT comprehensive certification, so you don't have to just take the vendor's word on the guarantee.
4. Find a doctor in your organization who has experience with implementing EHR technology, and seek his input on purchasing and implementation decisions. Network with other providers or the local or regional health information exchange as well.
5. Armed with the above advice, create a list of features you need before you go shopping for an EHR system.
6. Seek vendors who have a multiyear track record serving providers your size.
[Meaningful use] certification is a relatively easy activity. You don't have to be that good to be certified.
Wes Rishel, vice president and distinguished analyst, Gartner Inc.
7. Read the fine print: What do you get if your EHR software isn't meaningful use certified? Free maintenance until it is certified? More? Less? Make that information part of the comparison. Also, the meaningful use rules will be rolled out in stages, Rishel pointed out. Ask vendors what happens if they fail to deliver a software update in time for you to reap a HITECH Act incentive payment: Will they cover the cost?
8. Before buying, seek references from providers already using the combination of software applications you are thinking about assembling.
9. Avoid multiple applications in your EHR system. Forcing physicians to jump among interfaces while administering care is a formula for creating inefficiency and errors.
10. Keep in mind that the EHR meaningful use guidelines represent rudimentary functions. Plan on eventually doing a lot more with your EHR system, because the technology has so much more potential than those rules prescribe.
Rishel's last piece of advice: Solo docs and those in small group practices should plan on getting some outside help in installing a new EHR system -- even when a vendor swears it is possible to go it alone.
"Vendors who say 'Oh, our system is so easy to use that the doctor can figure it all out himself,' and who can point to a couple of users who have done that, are trying to convince you that their average user will do as well as their best user," Rishel said. "The best user is some guy who'd really rather be programming a computer, anyway. His parents wanted him to be a doctor."
Let us know what you think about the story; email Don Fluckinger, Features Writer.