I decided to take a step back this week for Meaningful Use Monday to look at where we are in the new world of health IT which includes the commonplace terms of EHR incentive money and meaningful use. Plus, I’m probably waxing a bit nostalgic today as I think about the David Brailer keynote at the Digital Health Conference today (follow my tweets on @ehrandhit for more coverage) where he spoke a bit about the origins of healthcare IT.
At this point it seems that meaningful use has become basically a commodity. There are very few EHR vendors out there now that aren’t certified EHR that can help a physician get to meaningful use (Although there are some non-certified EHR still). Basically, if you are doing EHR, then more than likely you are doing meaningful use. Or at least you’ll have that opportunity if you want. Some would argue that means that this result is a function of the meaningful use bar being set too low.
In fact, that is largely what the congressmen’s argument was in their letter to HHS about halting meaningful use. The real question is whether this is a problem. I personally don’t mind all the EHR competition. I think it would have been worse if the government incentive, meaningful use, and the RECs essentially narrowed the field of EHR vendors down to only a few.
The argument on the other side is around the “paradox of choice.” There’s little doubt that many practices are in a situation where there are so many EHR choices that they make the decision not to choose. However, I see this more as an excuse not to do EHR from people who didn’t really want to do EHR in the first place. I’m not sure these people would have been doing EHR even if there were only a few choices.
This does leave us with a challenging problem going forward. The EHR churn rate is going to go through the roof. David Brailer pointed this out today in his keynote and he’s right that it’s already happening today. Although, the majority of the EHR churn that’s happening now is from those organizations that are going after meaningful use. The major EHR churn rate of the future is going to come from EHR consolidation.
What does this all mean? Now more than ever, an organization needs to do good due diligence on the stability of the EHR software. Notice that I didn’t say EHR vendor. Just because you’re a large EHR vendor that’s financially stable doesn’t mean that the EHR software is safe (see Exhibit A and Exhibit B).
One thing is clear though, meaningful use and EHR are here to stay. There’s no escaping EHR. We’re finally back to the point where doctors are no longer asking if they should do EHR. Instead, they’re asking how, when and which EHR they should do. This is a very good industry trend.
Two observations.
1. This is on the word ‘commodity’. Just as Meaningful use has become a commodity, so has EMR / EHR in various ways. In fact, most EMR products are being sold as commodity. It is being ‘demanded’ as commodity from providers, it is being ‘presented’ as commodity by vendors. If you talk to any vendor, you really don’t see anything different. They will rattle of a list of things they can do, which is what everyone else can do, and then, oh we’re different because – we have better service, we have better this and that – really?
2. Second is around the Churn of EMR – I’m observing this already. I see around 50% seekers looking for a change. These are providers that have realized that EMR has to be more than just meaningful use. They want true efficiencies for their practice. They want ease of use, they want better service. They want everything better than what they currently have.