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July 26, 2010

EMR Stimulus Q&A: Do You Have to Use a CCHIT Certified EHR Vendor?

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AK sent me the following EHR Certification question:

Is it necessary to get CCHIT certified vendor just because you want to qualify for incentives or regardless you MUST go for a certified solution?

Because I make the case that one should go with the one that provides the most amount of value.

You only need to use a certified EHR (doesn’t have to be CCHIT certified either, but HHS Certified) if you want to get the EMR stimulus money. The only caveat is that if you don’t show “meaningful use” of a “certified EHR,” then in a few years there are 1-5% Medicare penalties for not using one and showing meaningful use. However, many people strongly believe that those penalties will actually never be implemented. Of course, that part is just conjecture and may or may not happen.

So, there’s nothing forcing physicians to use a certified EMR solution. More and more people are doing as you describe, ” go with the one that provides the most amount of value.” They make the valid argument that if you get $44k in EMR stimulus money and lose $50k in productivity then you would have been better to go with an EMR that can’t get you stimulus money, but still maintains or even improves your productivity (among other EMR benefits).

At one of my EMR stimulus speaking engagements, a physician came up to me after the presentation and asked, “If I don’t accept Medicare or Medicaid, then do I care about meaningful use or certified EHR?” The easy answer was, nope. He can just decide on the right EMR without having to worry about government requirements.

Some have suggested that insurance companies might impose the certified EMR or meaningful use requirements, but I personally think that’s pretty unlikely.

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    6 responses to "EMR Stimulus Q&A: Do You Have to Use a CCHIT Certified EHR Vendor?"

    1. # EHR Scope commented on July 27th, 2010:

      In the long term, any practice will gain from an EMR, so even if you lose 50k in productivity initially, the cost of less staff and greater efficiency will recoup that within a few years. Still, you don’t necessarily need to go with a certified EHR, but that will help the ROI initially.

    2. # Jojo P commented on July 27th, 2010:

      EMR is analogous to an ERP system (for manufacturing companies). In my experience an ERP system is only as effective as it’s implementation. No matter how good an ERP (or EMR, certified or not) system, it can never be successful if the implementation and user acceptance is not planned. A computer system is not just comprised of the software; there is a need for implementors (consultants), software developers, data operators, users, computer hardware/infrastructure, etc. I would rather go for a non-certified EMR software that will meet my needs and planned accordingly to ensure sucess in implementation, rather than a certified-EMR system that will cause the downfall of my operations. Of course, if you find a certified-EMR that will give you both is an advantage. But good luck with that , because certification is almost always a front for the rich software companies’ lobbying efforts (my opinion). Therefore, don’t be afraid to consider some open-source (like free) EMR software. One that I have been eyeing for is OpenEMR. They try their best on getting their software certified yet they are free, as in no obligations. And then again, you may have to add your own software development for your own customizations, but any other EMR software will still require some software customization.

    3. # Al Borges MD commented on July 27th, 2010:

      Excellent article, John!

    4. # archer commented on August 8th, 2010:

      I wrote my own emr and have been using it for many years now. I did so because I was fearful that most programmers wouldn’t understand the logic in how doctors think and would orient their programming for the benefit of bean counters. Additionally, I see many chronic patients plus ADHD patients, and so I wanted a program that I could customize to suit my patients. My fear is that the government will force me to use a program that is inefficient and expensive. I don’t want to use a program where I have to enter a complex security code everytime I desire to access a patient’s file. The driving force behind many federal regs seems to derive from irrational security fears that typically do not come to fruition in a small doctor’s office.

    5. # John commented on August 8th, 2010:

      archer,
      Sounds like you’ve got a good thing going. I can’t imagine any government program making you want to change what you’re doing.

      I imagine even if they make it to the full 5% penalties (which I predict will NEVER happen), you still would rather use your own in house EHR.

    6. # CCHIT Certified EHR Becoming ARRA Certified EHR | EMR and HIPAA pingbacked on August 30th, 2010:

      [...] Also this post: EMR Stimulus Q&A: Do You Have to Use a CCHIT Certified EHR Vendor? Related ArticlesPreliminary ARRA Certified and CCHIT [...]

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