Information Blocking and EHRs

You never know who you might be sitting next to!

This past weekend was quite busy for our CXO, Bennett Lauber. On Saturday he was at a studio being interviewed about the Internet of Things (IoT) and usability and user-centered design ( see The Tech Show. On Sunday he was at a local swim meet with his son, who was competing in several events. For any parent, you want to always "Be There" for your kids even when it means sitting in the stands for 5 or more hours waiting and watching them compete.

After a few hours of listening to music on Spotify, reading the news on his phone, etc. he began chatting with a few of the people sitting near by. Eventually, the conversation topic moved onto work, and what each of us do for a living. One person was a "Cognitive Ergonomist" and another was a doctor with a lot of negative experience associated with the cloud-based EHR that is used in their practice.

Of course, our CXO -- the cognitive ergonomist, was VERY interested in learning about the trials and tribulations of the EHR, and any of the various problems they were dealing with. It was great to speak candidly with a provider on the front lines of the EHR usability. The conversation drifted towards the government incentive program design to move physicians to EHRs (they called it "Meaningful Abuse") and the "Safety-enhanced Design" (aka usability) program. They mentioned that their current EHR vendor isn't meeting their needs and they have begun working with another vendor.

They mentioned that the current vendor charged them some $1,200 for creating a backup of their patient data, and that they were VERY concerned that they will not be able to import that data into their new system. We spoke about some strategies for exporting and importing data between EHRs for the entire practice. Also most EHRs have a "Blue Button" type function for a patient to get a summary of their healthcare record as an XML file in the CCDA format, there isn't really a way to switch to a new EHR. EHR vendors know this, and know that it is in their financial interest to keep the data on their cloud in order to force their customers to remain customers.

Starting the January 2019, with an overwhelming majority of existing EHRs not fully certified and therefore rendering their customers not qualified to receive the full reimbursement for MIPS/MACRA, their will be a flood of providers wanting to switch to an EHR that IS certified. No one wants to get hit with the 25 percent reduction in payment (for medicare patients). This is a preview of a huge problem that many providers may run into in the next few months. As of today there are 169 EHR that are certified for the ONC 2015 edition for Safety-enhanced Design, and over 4000 that were certified for the 2014 ONC certification.

What can be done? How can providers get THEIR data from a cloud-based provider that goes out of business? We're going to keep an eye on this issued and report back when we have additional information to share. You never know who you might be sitting next to, they might just inspire a blog post!