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EHRs: Change is coming in 2013

Sean Brooks, in his article 5 EHR predictions, very astutely anticipates several upcoming changes related to Electronic Health Records:

  1. 2013 will be the year of the replacement EHRs
  2. Many EHR vendors will disappear
  3. The cloud is here to stay

I believe Sean is spot on and I would like to expand on this based on my research and opinions.

Many physicians jumped on the EHR bandwagon to secure Meaningful Use funding for Stage 1.  In fact, some only had to show proof of intentions to collect a check.  Others jumped off the deep end and installed EHR systems only to spend a long time learning the system.  After investing a lot of time in the setup and learning the new system, they realized it doesn’t support their practice.  I’ve spoken to a lot of physicians who feel betrayed and are angry with their EHR vendor.

2013 will be the year these systems with shortcomings get replaced.   Physicians are realizing there are better options on the market and the cost of upgrading is far lower than the cost of continuing to use systems that restrain their business.  There are EHR systems that are designed to adapt to the physician practice instead of forcing the physicians and their staff to change.  Then, there is Meaningful Use Stage 2.  A lot of systems who enabled Stage 1 will not be upgraded to enable Stage 2.  Physicians will be forced to replace their EHR system if they wish to attest for Meaningful Use Stage 2.

EHR vendors will disappear.   The 2014 requirements to certify a system to attest for Meaningful Use Stage 2 are far tougher than the requirements to certify an EHR system in 2011.  Certifying under the 2011 rules was primarily done by sending data that passed a specific set of tests.  In some cases, this was hardcoded for the test and in a production system no longer worked.  The 2014 requirements ensure the EHR vendor’s systems pass legitimate data.  It is no longer possible to pre-pass these tests.  Because of this, I too believe many EHR vendors will leave the business.  Smaller shops that do not have the reach and resources to certify for 2014 will sell out or quit.  Large, inflexible companies will take too long and choose to sunset their EHR products.  Physicians looking for EHR systems this year must be better informed.  They need to exercise care and scrutinize their vendor before jumping into another solution that doesn’t work. Everyone must use a 2014-certified EHR to attest for Stage 2.  One consideration is that those purchasing 2014-certified EHRs can also use them to attest for Stage 1.

Finally, I agree that cloud-based systems are a very smart idea for smaller practices.  It takes a lot of money, staff, and time to build and manage an internal network to host EHR systems.  Independent physician practices should seek out cloud-based EHR offerings so they can focus on what they do best and let the EHR vendors manage the network.   It is smarter to host your EHR in the cloud for several reasons:

  1. Cloud systems are designed for high availability. Independent physicians cannot afford the infrastructure and Information Technology resources to do this themselves.
  2. Cloud systems are expandable.  As data and bandwidth volume grows, cloud-based system can quickly grow (or shrink) to accommodate this.  On-premise solutions are not this nimble.
  3. Cloud is cheaper.  You are sharing systems with other users and can leverage economies of scale.
  4. Cloud is secure.  Although this is a shared service, all competent EHR vendors designed their systems to support the security needed in a shared environment.  This model is also the model supported at most in-house hospitals and larger data centers.
  5. Cloud is interoperable.  As the fog lifts for Meaningful Use stage 3, we can expect more requirements for interoperability.  Hiring an EHR in the cloud is a strong first step.

2013 is a year for some very good and reasonable changes.  What are you waiting for?

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