Monday, February 21, 2011

Why Should You Worry About Your Next EHR Now?

While you are looking for a new EHR to qualify for Meaningful Use, it is not too early to think about what you are going to do when you stop using this new EHR and move to the next generation of EHR products in (hopefully) a number of years down the road.

The significant and troublesome barriers to moving from one EHR to another and the vendor issues that impede such moves are a strategic concern for anyone buying an EHR.

Indeed, many early EMR adopters are in the process of moving from an old product that didn’t qualify for certification, became obsolete or no longer meets the needs of the practice to a Certified EHR.  These EMR pioneers are encountering expensive and problematic moves in which they are losing information, and not capitalizing on their painstakingly collected old EMR information. 

There are a wide range of reasons including changes to coding systems (Ex. Some old products do not use NDC codes in the medication modules) to incompatible medical note and information structures.  However, the overriding issue is frequently the limits to what the current EMR vendor is willing to provide and the information that the new EHR vendor is willing to accept.

Such a situation is difficult and costly now, but could pose a whole range of medical professional liability, practice disruptions, and compliance risks in the future.  For example, the inability to transfer your patient health information to a future EHR could prevent you from producing appropriate patient lists that meet a clinical criteria (A Meaningful Use (MU) Criteria and, within a few years, probably a standard of performance for practices and healthcare organizations.)  Similarly, how will you provide patients with access to their health information (another Meaningful Use Criteria) if the EHR information cannot be properly posted to a future EHR?  Indeed, as the MU Criteria frame the standard of care, a smooth and complete segue to a future EHR will become a necessity to maintain the patient record and demonstrate due diligence in protecting patients.

Unfortunately, most EHR vendor contracts do not adequately provide for an effective exit and transition strategy to a future EHR replacement.  In most cases, your EHR support and/or use can be terminated without providing adequate time for a transition or even a commitment from the EHR vendor to support the transition.  Indeed, the Application Service Provider EHR vendor model is based on continuing payments to use their software and access your data.  In more and more cases, EHR vendors are basing continuing use of licensed EHR software on continuing support payments.

This is not an academic discussion.  The contractual relationship established in your EHR contract will surely be used to frame and control the vendor’s relationship with your organization.  You should make sure than any EHR contract provides for an exit strategy to a future EHR:

Allow Adequate Time for Your Organization to Select, Implement and Transition to a Future EHR.

Support the Transition of Your Data from the EHR Vendor Structure to a Future EHR.

Provide All Data in a Format that Could be Used to Load a Future EHR:

Facilitate Continuing Access to EHR Data Until You No Longer Need the Former EHR

Ideally, the EHR you are choosing today will not be replaced.  However, the reality is that you need to assure that your patient data in the new EHR can be used to maintain the patient’s medical record and meet the evolving Meaningful Use Criteria based standards of care regardless of the events in the EHR industry and the evolution of your healthcare organization or practice.

(c) Sterling Solutions, Ltd., 2011

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