One EHR Vendor’s Experience with Meaningful Use Stage 2 Certification

I always love hearing from the CEO of EHR vendors. One that never disappoints is a man that most people in the EHR world have probably never heard of. His name is Michael Archuleta and he’s the Founder and CEO of a company called ArcSys (RedPlanet is their EHR). In response to my article on ComChart not going after meaningful use certification, he sent me a newsletter he recently sent his staff and some other side comments. They provide some real insight into the 2014 certification process and meaningful use stage 2.

Excerpts from the newsletter:

ArcSys has invested heavily in meeting the demands of Meaningful Use Stage 2. Whereas we thought Stage 1 was difficult, Stage 2 has taken substantially more time to meet the requirements.

We are not alone in meeting these challenging complexities. In reading the Internet chatter, there are other vendors who are facing the daunting task at hand.

ComChart Medical Software, has thrown in the towel by saying, “In addition to the Meaningful Use mandates, there continues to be a never ending stream of new mandates such as ICD-10, PQRI, Meaningful Use 2, Meaningful Use 3, SNOMED, ePrescribing, LOINC, Direct Project, health information exchanges etc. As a result of the mountain of mandates, ComChart EMR and the other small EMR companies will have to choose to implement the mandates or use their resources to add “innovative” features to their EMR. Unfortunately, the small EMR companies do not have the resources to do both.”

Obviously, ArcSys does not share this same viewpoint. If we can do it, then it means anyone should have been able to do it, too. We are either smarter (not true) or we had a superior software design from the beginning (probably quite true). The first round of software development has now been completed and we are prepared for certification. Our certifier, the Drummond Group, has a backlog of systems to be tested and have given us a mid-April test date. Having completed this development, we know with great precision what each doctor will have to do in order to meet MU2. And, yes, it will be difficult.

There are 37 testing “points” that we have focused on. It took us two months to do 36 of these points and another two months to do the remaining point (clinical quality measures). Many of the testing points had literally hundreds of scenarios to evaluate. There were situations we would discover after working for weeks that necessitated going back to the beginning and having to start over on retests.

Now for some really interesting bullet points on meaningful use stage 2 certification:

ArcSys has to be the tiniest company on the planet seeking MU2 certification.

Yes, I dislike the extra burdens being placed on providers for MU2.
Yes, I dislike the vague (non-existent?) guidelines on how to properly use SNOMED, Rxnorm, and LOINC.
Yes, I dislike the committees who dream up measures and certification rules that have little relevance to how docs like to treat and interact with patients. Do they really believe MU2 and seeing 40+ patients/day can co-exist??
Yes, I have written every line of code for our product to handle MU2 and I know of flaws and weaknesses the testing tools are ignoring.
Yes, I hate being pulled away from being able to work on software enhancements.
Yes, we were naive in thinking that MU2 would take as much time as MU1 to develop and test. It was easily 10 times more complicated.
Yes, I dislike wading through the Google/JIRC posts to see what other hapless souls like me our stumbling for answers regarding certification.
Yes, it is nearly impossible to read any document produced by HL7.org and find helpful guidelines.
Yes, I dislike the Cypress testing tool.
Yes, I dislike the XML bloat for reporting measures and transporting patient data.

So, why do we continue? Simple. We made a commitment to our client base who likes our service and support. And, in the end, we’ll be as conversant as anyone on the ins and outs of MU2.

How’s that for a real look at some of the nitty gritty EHR vendors face when it comes to 2014 Certification and meaningful use stage 2?