An EHR Focused On Customer Requests, Not MU

I love taking email exchanges I have with practicing doctors and making their comments into posts. This is one of those cases. The following is a quote from an email I got from a physician friend of mine about his EHR (EHR name removed):

Every time we turn around these days our EHR vendor is adding some new update. Sometimes the updates change the format of how the system appears and functions, sometimes they don’t. Unfortunately, the people who are still chasing after all the crazy government hoops to jump through and those who are not are all forced to deal with the same EHR software system. I really wish there was a separate system with no crazy upgrades that would function the same way that the system did two years ago. That was a much simpler and more commonsensical system. It’s a really sad case of the government says jump and software systems say how high?

I believe this physician has stopped taking Medicare patients and has happily avoided meaningful use. However, as the above comments illustrate, he hasn’t avoided a lot of the impact that meaningful use has had on the design of his EHR system. Plus, that doesn’t even count all the great new features that this doctor could have gotten from his EHR if they weren’t busy turning on all the MU requirements including the MU reporting and tracking.

His comments about wanting a system that isn’t influenced by MU requirements is quite interesting since Pri-Med (the company that acquired Amazing Charts) has announced an EHR product called InLight EHR that’s not certified and doesn’t do MU. The press release says the EHR is designed for Direct Primary Care. This is a really interesting move by them, and my doctor friend above illustrates why an EHR software that’s not MU certified could work.

One challenge to this idea is that a lot of doctors can’t shun Medicare and meaningful use. So, they’ll need to continue with the EHR that are still chasing the government carrot and avoiding the stick. We’ll see how these different EHR markets evolve.

About the author

John Lynn

John Lynn

John Lynn is the Founder of, 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,, 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.


  • What happens after MU-3? Will physicians need to continue meaningful use activity to not incur penalties? Is this a never ending saga?

  • Our customers are oncology specialists and have chosen not to go with Meaningful Use, as well. Not because their EMR is not certified, but because of simple business arithmetic:

    (#Medicare Visits)*1.0 – (Cost of staff time for data entry) -(lost MD time responding to patients un-reimbursed) – (legal fees)*(Risk of audit ) < (#Medicare visits)*.98

    Or, to simplify:
    Salary costs and legal risks are greater than medicare penalties.

    Also notice: There are no '+' items on the Meaningful Use side of the equation, only negatives.

    And that's just the money – not taking into account the mental yoke of conforming to CMS's ill-conceived and arbitrarily changing guidelines. How can you effectively run a business when playing by such rules?

    This may not be true with non-specialists who do not have an alternative to E+M Revenue, but the math is quite clear for our clients.

    We are much happier to deliver meaningful improvements to our software per user request and not per government mandate.

    The days of legislation-based software are hopefully waning.

  • Couldn’t agree with you more Nick,
    As surgical specialists, we opted out of MU from day 1. We looked at the onerous requirements, the huge loss of efficiency, risking audits, for software who’s sole purpose is to jump the hurdles of MU. CMS mandated MU EHR for all patients, though they only cover Medicare Part A or B patients. Riddle me that one. There is no incentive for EHRs to push usability, customization/efficiency, even safety or security. We stuck with our non MU certified customized product and have not looked back. There is just no way the EHR incentives will come close to the costs of implementation and maintenance and support. Penalties will only ice the MU program. When have penalties ever worked? Never. Who is going to pay for an EHR product if they are getting penalized by Medicare? We would rather just cut Medicare out of the equation. Take our lumps. Which is much easier and less expensive to do. I am curious to see how ONC spins the MU 2 numbers that are due at the end of the month. Right now only 15% of EPs that are required to do MU2 have done it. But really only about half have done Stage 2, as the other half are using the Flex Rule and reporting Stage 1. So only about 8% have attested. That leaves a huge majority of EPs that are about to give up on MU. At some point ONC and CMS has to actually listen to EPs.

  • Nick,
    That’s a complicated equation, but definitely illustrates the picture that many doctors face.

    Your commentary has me interested in doing “Physician Stories” videos where they read a letter to the government talking about the challenges their facing. What do you think of the idea? Might be interesting to put a face to the story of doctors who are struggling with all these changes.

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