Lack of 2014 Certified EHRs

I was asked recently by an EHR vendor about the disconnect between the number of 2011 Certified EHR and the number of 2014 Certified EHR. I haven’t looked through the ONC-CHPL site recently, but you can easily run the number of certified EHR vendors there. Of course, there’s a major difference in the number of 2011 certified EHR versus 2014 certified EHR. However, I don’t think it’s for the reason most people give.

Every EHR vendor that gets 2014 Certified likes to proclaim that they’re one of the few EHR vendors that was “able” to get 2014 Certified. They like to point to the vast number of EHR that haven’t bridged from being 2011 Certified to being 2014 Certified as a sign that their company is special because they were able to complete the “more advanced” certification. While no one would argue that the 2014 Certification takes a lot more work, I think it’s misleading for EHR companies to proclaim themselves victor because they’re “one of the few” EHR vendors to be 2014 Certified.

First of all, there are over 1000 2014 Certified EHR products on ONC-CPHL as of today and hundreds of them (223 to be exact – 29 inpatient and 194 ambulatory) are even certified as complete EHR. Plus, I’ve heard from EHR vendors and certifying bodies that there’s often a delay in ONC putting the certified EHR up on ONC-CPHL. So, how many more are 2014 Certified that aren’t on the list…yet.

Another issue with this number is that there is still time for EHR vendors to finish their 2014 EHR certification. Yes, we’re getting close, but no doubt we’ll see a wave of last minute EHR certifications from EHR vendors. It’s kind of like many of you reading this that are sitting on your taxes and we’ll have a rush of tax filings in the next few days. It’s not a perfect comparison since EHR certification is more complex and there are a limited number of EHR Certification slots from the ONC-ATCB’s, but be sure there are some waiting until the last minute.

It’s also worth considering that I saw one report that talked about the hundreds (or it might have been thousands) of 2011 Certified EHR that never actually had any doctors attest using their software. If none of your users actually attested using your EHR software, then would it make any business sense to go after the 2014 EHR certification? We can be sure those will drop out, but I expect that a large majority of these aren’t really “EHR” software in the true sense. They’re likely modularly certified and add-ons to EHR software.

To date, I only know of one EHR software that’s comes out and shunned 2014 Certified EHR status. I’m sure we’ll see more than just this one before the deadline, but my guess is that 90% of the market (ie. actual EHR users) already have 2014 Certified EHR software available to them and 99% of the market will have 2014 certified EHR available if they want by the deadline.

I don’t think 2014 EHR certification is going to be a differentiating factor for any of the major EHR players. All the major players realize that being 2014 Certified is essential to their livelihood and a cost of doing business.

Of course, the same can’t be said for doctors. There are plenty of ways for doctors to stay in business while shunning 2014 Certified EHR software and meaningful use stage 2. I’m still really interested to see how that plays out.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

6 Comments

  • What an absolutely crazy business.

    All these healthcare IT companies both existing and launched to ‘race across the country to dig for gold at Sutter’s Mill’. Companies creating all sorts of applications and getting tested to be acceptable against some made up criteria by testing companies launched ‘like trading posts to serve the prospectors’. And then the government establishes new testing standards and when companies get that certification nobody cares and the government doesn’t post those new achievers on the website of honor. And then to find out that the docs aren’t even attesting.

    Does anyone else think this is crazy? All this money being spent around in a circle with little value getting spun out affecting anything outside of the vendor circle.

  • It is indeed Don. I believe we will see the collapse of MU late this year or early next. I’ve spoken with many doctors that have said “the money is just not worth it now”. Many are facing a huge expense to upgrade from Win. XP. They did “dodge a bullet” with the delay in ICD-10 and the 24% SGR cut. But many primary care docs have had enough…it will be interesting to see how the rest of 2014 plays out.

    As of yesterday, there are only 100 companies that are complete ambulatory that are 2014 certified. The website shows 194, but many companies have multiple products.

  • I couldn’t agree more with these comments. I am always hoping someone posts how many are attesting to MU2 for EPs. I am betting a low teens or less. I cannot find any numbers there on CMS site. With the “average” Medicare payment to EPs (just recently released for 2012) at $89K, a 1% penalty would mean $890 bux. Even at 3% it would only be $2700. The costs of the software/hardware/OS updates/service/support is WAY more than that. And the hit to productivity and attestation to MU 2 with the risk of audit, I predict a total meltdown this year also. Achieving MU1 was easy, from here MU2 is a pipe dream, thought up by non-working Washington types that really don’t see patients or know much about real medical practice, no matter what they “think” they know. Forget MU3. With the programs payments to EPs dramatically less for achieving MU2, I expect a complete abandonment of the program. No one is going to attest every year to keep from getting a 1, 2 or 3% penalty. Someone on the inside please get the MU2 numbers for those early adopters. Show me the numbers. I bet they are frighteningly low.

    Also,I think ICD-10 was dropped because CMS wasn’t ready. How come they could not do end to end testing with me if I wanted to? And they were only going to test 30 EP/groups in Ohio, and not everyone that was interested? Who cares what some other group can do, I need end to end testing for my group. And CMS doesn’t need another government computer disaster RIGHT before an election. So it was politics, folks. Not pressure from us.

    Kudos to ComChart and Dr Z for being ahead of the curve and giving up on MU. I know they have customers. I’m not one, but I know that they care about their customers and the experience. At least they had the kahunas to come out and say it, and not just fade off the MU money train. They want a good EHR experience, not what ONC thinks is good. Soon ONC and CMS will realize that
    EHRs are VERY expensive, and require lots of upkeep and EPs don’t need them in our way to see patients, we need a good efficient experience. And with customized and continual efficiency updates, not the ladled on government mandates that some policy wonk feels is important. Every practice is different, even within specialties/primary care. Do you think a GI practice is the same as Cardio, is the same as Ortho is the same as Family Practice? EHR companies will have to customize for every type. And right now they can’t even keep up with silly MU mandates. Forget efficiency. Forget a good experience, they just need a product that can be certified for 2014. That will lead to an exodus from the program. Mark my words.

    Goodbye MU. EHRs will still exist but no one is going to care about being in the MU program. MU2 killed the program. Show me numbers for MU2 attestation and tell me I’m wrong.

  • You’ll see the numbers on MU2 about the same time we get the REAL numbers for the Affordable Care Act.

  • All of you echo what I hear daily (I help private practices navigate all of this craziness).

    I will say, if your EHR vendor has their act together, MU 2 isn’t really a big deal…unless you consider changing your workflows (once again) in order to meet some cubicle dwellers idea of good metrics a big deal.

    Though I don’t come across many docs shunning MU (yes, some close to retirement do), but I do hear gripes all day about this and that.

    It is a shame, but I think the moral of this story is: watch out who you partner with.

    Once you accept money from the government, you give up many freedoms. Maybe not immediately, but at some point.

  • I wonder if 2 years from now we’ll look back at this post as foretelling of what was to come with the EHR industry and MU. Unfortunately, most are afraid to say it in public.

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