For the second time, the ONC has stripped an EHR of its certification, leaving any hospitals and providers who were using the product to attest to Meaningful Use (MU) out of luck; they must switch EHRs or drop out of the EHR Incentive Programs.
In 2013, it was two EHRs developed by EHRMagic, Inc. Last week, it was two versions of the SkyCare EHR, which had 48 providers using it to attest to MU.
Even without the issue of attestation, decertification of an EHR signals it’s time to move on for all of its users, experts say, whether or not that EHR’s vendor is officially discontinuing it or going out of business.
For an EHR vendor to be competitively viable, it must be certified, notes Dr. Adam C. Powell, president of Payer+Provider Syndicate, a management advisory and operational consulting firm. “As such, any vendor wishing to continue its viability will take the steps necessary to ensure it continues to be certified,” Powell tells Healthcare Dive.
Decertification would likely be a symptom of discontinued maintenance and trouble with the vendor, Powell says. That appears to be the case for the two decertified versions of SkyCare 4.2, developed by Platinum Health Information Systems, Inc. ONC says Platinum Health failed to respond and participate in routine surveillance requests, and HIStalk notes its website was down.
Powell says a provider is not in a good position if it’s using an EHR from a defunct or under-performing vendor because EHRs need to continually evolve. They require annual coding updates and modification to meet the requirements of incentive programs, he says.
“Likewise, compliance with future Meaningful Use requirements necessitate changes,” Powell says.
And while EHRs can be sold as both products and services, even the most “product-like” EHRs inherently have a service component due to the need for updates, Powell adds.
Providers should take extra care when considering EHRs from smaller or less-established EHR vendors, Powell suggests. Providers should ensure that mechanisms are in place to transition patient data to other platforms, and they should factor the cost of a potential transition into the purchasing process.
Even with such precautions, providers are taking a risk because even the most carefully planned transitions between EHRs tend to be costly and time-intensive, Powell says. “An emergency transition due to vendor failure is likely to be even more disruptive, as it must occur more rapidly and is more likely to require people to work overtime."
When EHRMagic was decertified, Stephen Stewart, healthcare IT consultant at TruBridge and former CIO at Henry County Health Center in Mount Pleasant, Iowa, shared similar sentiments. “My view is this is nearly catastrophic to the users," Stewart told FierceEMR. "But if the product is bad enough to get certification revoked, moving on is probably in the best long term interests.”
A blog at that time from the ONC's Carol Bean, Director of Office of Certification and Testing, and Asara Clark, Program Analyst, details their EHR monitoring process. They wrote the Office of Certification’s role doesn’t stop after EHR certification and they engage in both proactive and reactive surveillance, which can be triggered by user complaints and questions.
"The doctors, hospitals and other providers that are adopting – and have already adopted – EHRs deserve this and should feel confident that the tools they are using are up to the job of helping their patients get the best care possible," they write. "If they don’t, we want to hear about it."
As for how to recover in terms of participation in the Medicare and Medicaid EHR Incentive Programs, the ONC's latest announcement directs providers who are using the decertified EHR products to apply for a hardship exception from the Meaningful Use payment adjustments while they transition to a new certified EHR.