Meaningful Use Challenges – software or process?

Responses continue to roll in after the Dec 30, 2009 final rule proposal from The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC).  As expected, there are some positive and some critical comments.  From reading them, one cannot help but wonder what percentage of the challenges raised are due to poorly designed EMR (or EHR) software and what percentage are due to clinical processes that resist change.  I suspect a good portion the problems are due to software.

EMR and EHR software have been in the market for many years, though many have not  delivered on their promises.  In fact, a friend in the business once said the product he sold probably bankrupted a number of medical practices due to problems with the billing and other modules.   Those who have purchased these software and experiencing problems are rightfully concerned that they not only have to spend money to swap out their current EMR, but they may also lose out on the EHR incentive money.

However, from an objective observer and healthcare consumer’s point of view, I believe the Meaningful Use goals are worthy and necessary.  What needs to happen is for the software vendors to respond to the complaints of the purchasing doctors as well as Meaningful Use requirements.  This press release by research firm KLAS points out some of the feature gaps that need to be plugged.

There is indeed a market opportunity for EHR and Health 2.0 tools delivered as SaaS as The Health Care Blog says.  They are more flexible, more integration friendly and less costly to implement (at least from an infrastructure perspective).  Those who have already implemented a clunky and inflexible system, ironically these are probably hospitals and financially endowed practices, can be seen expressing concerns such as “unreasonable threshholds for some meaningful use criteria, including computerized prescription order entry, electronic claim submission and electronic insurance eligibility verification”.

This will continue to be a space to watch, whether you are a technologist or a medical professional.  There is hope yet EHR will learn from consumer web innovations that millions have been using for a number of years.