The hard work of thrashing through requirements and building new features for meaningful use (MU) stage 2 has come to an end for most electronic health record (EHR) vendors. Analysis of what must be done for stage 3 has begun, but those features won’t be needed until 2017. In addition, there have been numerous stops and starts for the use of the International Classification of Diseases, 10th edition (ICD-10), the new compliance date for which has been put off until Oct. 1, 2015. That’s a long hiatus from what are essentially regulatory requirements, and savvy EHR vendors have an opportunity to use that time wisely.
We wondered what EHR vendors plan to work on in the interlude between MU stages and ICD-10. At the recent annual meeting of the Medical Group Management Association (MGMA) in Las Vegas, we learned that many EHR vendors are using their time productively to:
- Address customer-requested enhancements. Those we spoke with for this article lament the good old days when the majority of product enhancements came from users. That hasn’t been the case since HITECH. You see, despite its benefits, MU has taken up the vast majority of development bandwidth, first in a rush to incorporate functionalities and later to optimize them. It’s not clear who struggles more with this pace of change – the EHR vendors or their clients. One thing is certain – the delays have presented an opportunity to focus anew on customer-requested enhancements.
- Tackle usability. It’s no secret that many physicians are dissatisfied with their EHRs. This has been confirmed by many studies, most recently one by the RAND Corporation. It found that EHRs worsen physicians' satisfaction in areas such as increased time performing data entry, interference with face-to-face care, interfaces that don't match work flow, poor health information exchange and a mismatch between MU and clinical practice—all of which may adversely affect patient care. Smart vendors are using this hiatus to make work flows more efficient and optimize their products for usability.
- Revisit outsourced functionalities. Many vendors have outsourced functionalities for ePrescribing as a shortcut to achieve MU stage 1 or 2 certification. While these bolt-on applications have served their purpose, vendors are now revisiting the need to outsource them and developing native functionalities that are more cohesive with the overall product offering.
- Avoid sharing revenue with other vendors. Two considerations of outsourcing EHR functionalities are cost of goods and sharing revenue with third parties. Some vendors are evaluating what they can do or change to cut out the middle man. When pass-through costs for partner products are reduced or eliminated, revenue opportunities increase. For example, one EHR vendor is replacing a consolidator for prescription co-pay coupons and working directly with sponsors’ direct physician messaging.
- Improve patient engagement capabilities. MU stage 1 introduced a need for physicians to provide patients electronic access to their medical information. Stage 2 added the need for physicians to conduct secure messaging with patients. Now that the baseline functionalities have been built and the rush toward MU certification has passed, vendors are doubling down on their offerings for patient engagement. Some are beefing up web portals. Some are adding or improving functions to make them more patient friendly, such as the ability to schedule appointments electronically, refill prescriptions, access and update their information and pay bills. Others are exploring innovative ways to provide educational materials and adherence programs, which are important toward improving outcomes and managing costs for patients with such chronic conditions as diabetes.
EHRs are, after all, a product offered by a business. It’s clear in our discussions with vendors that their focus during this cycle is on improving the usability of features that already exist rather than adding new functionalities. During this hiatus of MU-related development, they have an opportunity to listen to what that their clients want, which is to be able to more easily use features that they already have, and not add new ones. This strikes us as a very productive way for EHR vendors to differentiate themselves, create demand for products and increase market share.
Edited by Alisen Downey