Will Meaningful Use Stage 3 Continue to Kill EHR Innovation?

In my recent post on EMR and HIPAA titled “The Current EHR Reality,” L Parada, a product manager at an EHR vendor, offered this insightful and scary comment:

Looking at the 137 proposed certification requirements for MU3, I again see all innovation in 2016 slipping through the fingers of all specialty EHR companies. That stings.

I’ve occasionally mentioned that we’re finally at a more stable place with meaningful use that EHR vendors might be able to have some breathing room to innovate. Is that time frame for innovation going to be limited to 2015? Will meaningful use stage 3 ruin EHR innovation in 2016? I also don’t think that it just applies to specialty EHR companies either. That many government requirements is going to kill innovation at every EHR company of every size.

This would make me really sad. I’m tired of writing blog posts about the lack of EHR innovation. Can we just let the 300 EHR vendors get to work on listening to their customers and doing some creative solutions to really improve the efficiency of healthcare and improve doctors’ outcomes?

I think we all might feel different if we thought that the meaningful use stage 3 requirements were innovative and really pushing forward amazing initiatives that were going to transform healthcare. I don’t know anyone who really feels that way. At best they see it as a good step forward towards some noble goals. Should we kill innovation in the entire EHR industry for that?

With meaningful use stage 3 around the corner, it’s starting to feel a lot like meaningful use groundhog day. Does it feel that way to anyone else?

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.


  • Reality, or excuses not to innovate? I find it hard to believe that coming into compliance means you have to stop improving and innovating. Can’t they do both? It’s up to the vendors to ensure that the product continental to march forwars…especially true for a Product Manager.

    This feels like a bit of a cop out by the EHR vendors to me. Just my two cents.

  • Jerry,
    You might be able to create innovative ways to meet the requirements. Certainly not all meaningful use implementations are equal. However, the vastness of the meaningful use requirements zaps a development teams time. Plus, if you know about the mythical man month, you can’t just throw more developers at it.

  • IT’s a false choice. Most people know my stances on Meaningful Use (Check out THCB for Meaningful Use) and MU stage 3 is no exception.

    We have an Oncology Management Platform that includes EHR functionality. We are currently getting certified to MU2. There are a lot of items that make a lot of sense in MU, but in reality – when talking to real users, we have created such a unique, productive, specialized view of how to manage oncology that most MU features I have proposed to our users have been met with “Why would we ever use that?” or “That’s silly”. Rightly so.

    So ‘Compliance’ is a false quality metric, it’s saying “Yes, Sir!” and saluting a standard that isn’t useful for your customers.

    On the other hand,

    Every restaurant in America needs a health code, that’s what I see MU guidelines as now. They don’t mean the food tastes good, just that it’s mostly safe to eat there. Do we really need to fundamentally change the way health inspections are done each year in some desperate grasp to decrease healthcare dollars (that is at best a 50/50 shot of working)?


    So.. where was discussion of innovation in the above paragraphs? Trick question! I wasn’t there because that’s what MU does. It sucks the oxygen out of the room. We could be working on integrating with RFID cabinet chips or using wearable in-office tracking devices, or developing a patch that continuously monitors controlled substance levels or… we could go on and on…

    But instead we have to worry about “Emergency access”, reconciling all of our ICD9, ICD10 and SNOMED-CT codes. (That was a hard sell to our docs), and planning for what fresh new horror ONC will release by 2017.

    MU phase1 served its purpose well. Meaningful Use stage 2 has brought a dark age upon the healthcare IT landscape. Let’s hope MU stage 3 is allowed to peacefully pass into the abyss.

  • MU is dead, MU 3 as proposed will just beat an already dead horse or as I have said before, bury the body.
    Imagine a world in which developers had time to work directly with end users for more efficient, safer, more secure, and more usable products, instead of chasing their tail trying to meet 137 certification requirements of some idealized EHR that is a one size fits none program. Its like ONC is using 137 criteria to force everyone into a Ford Econoline Van. It fits all the requirements for some government vehicle, but I don’t want to drive one. We are all forced to use the same van with different colors essentially. We are dying for a Tesla, but there is NO room for innovation, as we are way too constrained on the someone else’s idea of an EHR. With basically single digits of MU 2 users, ONC should be hearing loud and clear that what they are doing is NOT working. But they are tone deaf to a fault. So MU 3? Good luck with that, those handful of informantic MDs. The rest of us have given up.

  • Nick,
    Thanks for the added perspective.

    You say that MU is dead, but I assure you it’s not dead in EHR vendors eyes. They still have to deal with it since some percentage of their customers (almost all) will expect their EHR vendor to be certified for MU3 even if they eventually end up choosing not to attest. So, it’s certainly alive even if it will die with lack of people doing it.

    In the hospital world it’s even more complicated, because it’s a lot of money for them not to do it (mostly penalties).

  • The innovation vs. MU debate is a red herring.

    Sure the demands of MU can be heavy (and, perhaps, not aligned with customer needs), but that doesn’t mean that the health IT product managers of the world can’t invest in thing in addition to MU compliance.

    It’s what differentiation in every industry is about and why most EHRs and health IT sucked BEFORE MU. Sucks during MU. And will suck post MU.

    Better health IT is in the hands of the vendors and their customers. MU is the cost of doing business.


  • Ron,
    I don’t think it’s a Red Herring. I agree that MU won’t change the complexion of who an EHR vendor was pre or post MU. However, show me the innovations you’ve seen happening in the EHR industry since MU and EHR certification. They are few and far between. Are you saying that all 300+ EHR vendors are using MU as an excuse to not do more? They’ve all just collectively chosen to suck (to use your words) and blame it on MU?

  • John – I agree that examples of true innovation in the era of MU are few and far between, but they’re there. Phytel (focused on PCMH needs and not necessarily just MU) and Health Catalyst (data warehousing) are a couple of examples.

    Some of the 300+ EHR vendors absolutely are using MU as an excuse not to do more. Even just fix bugs and known problems for existing customers.

    Some just aren’t capitalized, staffed or organized to deliver on the requirements of MU, let alone anything else.

    Some – especially big ones that, ahem, have had the time and resources to participate heavily on the MU FACAs – have sought (as a business strategy) to use MU/Certification requirements as a barrier to entry / resource drain for competitors.

    My point is that the MU vs. innovation debate is a red-herring because individual or collective investment resources to put toward MU, actually making better products or reinvesting the whole ecosystem and delivering on existing ones aren’t necessarily zero-sum.

    I lay blame as much at the feet of the providers who could have acted individually and collectively to shape MU/Cert in more useful ways (individually and collectively) and shaped the basis of competition in ways that could have made a difference and allowed entrants to focus on doing a few things really well (vs. having to maintain a whole stack).


  • Ron,
    The 2 companies you mentioned aren’t EHR vendors. I agree that there are some third party vendors out there doing some pretty cool stuff. However, they’ve not bogged down by MU which really illustrates my point.

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