Medical team using a laptop

Does Certification Mean an EHR is Ready?

I just received an email from a long-time EHR user trying to meet the Stage 1 Meaningful Use objectives. His story raises two significant concerns:

1) Are the additional costs for meeting the MU Core and Menu Set well beyond the potential EHR incentives — and more than what EPs are willing to incur?

2) Does the ONC-ATCB certification process lead to EHRs that can deliver on the MU metrics?

With his permission (and after just a bit of editing), I’ve excerpted the relevant parts of his message and posted it here — and I invite your insights/responses:

To date there are three areas of MU I have had difficulty meeting. The first is the “menu item” of reporting to state registry. My state is ready but my vendor is still working on the interface. Additionally the vendor was charging about $8,000 per practice for the interface. I have already spent $7,000 upgrading the hardware to the version compatible with MU and if I were to spend an additional $8000, $15,000 would be spent to get $18,000 [of the total of $44,000 over 5 years in the Medicare program]. Also if one of the two public health measures is required it should have been moved from menu to core.

I am also having trouble with core measures 12 and 13. For MU item 13 my vendor has not designed the form needed to produce the clinical visit summary. I have been giving patients a “chart summary” which has the necessary information but this is just a work around. The vendor does not have a report which captures this work flow and I have had to design my own report to generate the needed numerator and denominator. For MU 12 giving a patient an electronic copy when requested we have always been printing or using secure e-mail to give the information to the patient. But we are not capturing the numerator or denominator. Once again the vendor has designed a form but it is not functional. The vendor is aware of this but a release date has not been set.

I am in complete support of an EHR and the improvements to patient care that it can bring, but getting to meaningful use is problematic. It comes down to “control.” I can control the workflows in my office but I cannot get my vendor to produce a product that has all the necessary workflows to meet MU.

Is your certified EHR providing the functionality needed to meet each of the 15 Core Measures in Stage 1 of Meaningful Use? Not sure? Here is a table in Word format [Core Measures]. Give it to your practice manager or person responsible for getting your practice up to speed on Meaningful Use. Ask her/him to simply check off the Core Measures for which s/he is confident about successfully reporting. Then reply to this post with the results. Sometimes real-life stories from physicians in practice can generate insights that no survey or statistical analysis can provide.

If you need a simple document that links to all of the Stage 1 Meaningful Use measures (Core & Menu), this PDF from CMS will do the trick.

This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.

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