Amidst a still-faltering economy, the bright spot has been healthcare IT, thanks to ARRA and its HITECH Act. Just as there is a lot of hope and energy invested in moving the healthcare industry into the 21st century, there are equal parts of anxiety and pessimism that billions of dollars will be spent without transforming the industry in the form of increased quality and efficiency of healthcare delivery, and reduction of medical errors and cost.
I meant to compare the vendor listings for EMRs and EHRs from the HIMSS 2009 Resource Guide to the HIMSS 2010 Resource Guide to get an idea of how the market has expanded significantly because of the federal incentive programs, but the categorizations are very different. This year, there were sub-categories within the categories, which indicate a more complex EMR/EHR market.
With the focus of a chunk of the funding, particularly for Regional Extension Centers, or RECs, on the priority primary care provider, it's no wonder so many new companies are chasing the small physician offices and rural and community health centers and clinics, a market traditionally shunned by the big EHR/EMR vendors.
Some healthcare leaders, such as John Halamka, MD, CIO, CareGroup Health System, Harvard Medical School welcome this period of innovation. Others, such as David Brailer, MD, former head of ONC and now chairman of healthcare investor firm Health Evolution Partners, see a fragmented vendor market that in its current state offers no clear winners or losers.
Given the state of other industries, this is an enviable position for the healthcare industry to be in. If the deadlines remain the same when the meaningful use criteria are finalized, providers will not have the luxury of waiting for the market to shake out. What to do? First and foremost, stick with a vendor that has been certified by either a temporary or permanent certification body.
All healthcare is local, but as part of due diligence check in with healthcare organizations across the country that are similar to your organization and have implemented an EMR or EHR. Which vendor did they select and why? Don't rely on one healthcare organization. Talk to many. I think of my pharmacist brother-in-law who hates his clinic's EHR, which is a well-known system. Not that either side is wrong; it's just to say that for whatever reason his organization is not benefiting from this particular product.
When those RECs are up and running, take advantage of their resources, so deploying best practices will ensure efficient processes and implementation. Reach out to one of the 15 beacon communities, which were chosen to serve as model for demonstrating the success of healthcare IT.
I don't think guarantees of meeting meaningful use that some vendors are advertising have that much bearing. Do you automatically shun companies less than a year old? It depends on their product, leadership and executive and development team (and the background and reputation of the vendor’s leaders).
Regardless, the fragmented market will evolve - probably not as quickly as we'd like - but it will evolve with a lot of innovation. And hopefully without smoke and mirrors or ideas jotted down on cocktail napkins….
