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Friday, September 22, 2006

Comments

William Bryson

Okay. I can see this is a debate that wants to be had. I'm glad that's the case. I do however, want to point out that my original post - while clearly leaning toward pro-CCHIT - doesn't explicitly anoint the model as the right answer. It is, rather, an answer to a question that clearly needed addressed.

Having said that, I want very much to address the issues raised by Joseph and Al. I think their well reasoned posts deserve the respect of an intelligently thought out reply. I still believe, fundamentally, that the CCHIT standards are a good thing and that while each case may be different - and sometimes unfortunate - the overall effect will be positive. I don't hear anyone suggesting that it's good to have over 400 EHR products to choose from. So, while we may not agree about the methodology, we can agree (I hope) that there needs to be a (serious) winnowing.

From there, I'll defer for the time being and do my homework. Look for a post in the next couple of days that addresses this issue in greater detail. I love the fact that we've got some debate going here, I'd like to continue it in more depth. If either the two gentlemen who have already posted or anyone else out there wants to get involved, please don't hesitate. I learn a whole lot more from idea exchange than from pontification!

Thanks.

Al Borges MD

>>>but right off the top I'd say this: I think my argument was to let the market figure it out. I think that CCHIT standards serve the purpose you propose: "First establish the standards, publish the standards on internet, let EMR vendors write software conforming to standards." No one is being forced to certify; no one is being forced to buy certified product. That's the market at work.

Hi William:

In the case of CCHIT, the HHS and other insurance companies have decreed that they will only offer doctors incentives if said physicians have CCHIT-certified systems. In the case of Medicare, that's tantamount to carving CCHIT into law, which will at the end force doctors to comply. Why would a physician who sees Medicare and PPO patients purchase an EMR if you'd have to drop all your patients or take a pay cut? Inexpensvie EMRs from small vendors will then get squeezed out of the market. Physician overhead will increase exponentially.

Taking a "laisser faire" position towards CCHIT will only allow them to become entrenched into society further. Would you do that with a New York mobster family? No- what they are doing is in my eyes is just as criminal, bypassing our anti-trust laws in the name of improving the medical system in the USA. BTW, it's not just the USA- this month CCHIT set up an office in Belgium in their quest to take over the world.

This collusion between CCHIT and the HHS will kill off any real competitive market forces and we should all stand up and complain loudly and forcefully.

BTW, Joseph, you don't have to look at PanAM for a bankrupcy. The biggest EMR catastrophies haven't been with the big, expensive EMRs. The cost of an EMR is NOT associated with an increased risk of IT company failure. In fact, the 3 most recent EMR bankrupcies were high-priced systems- Alteer, MedicaLogic and Dr. Notes. Medicalogic/Logician was eventually purchased by GE, but Alteer and Dr. Notes were messy breakups. Praxis let 7 years pass before its recently introduced v. 3.0 and has lost many of its diehard users and only recently has made a decent comeback, but there was one http://emrupdate.com user that complained of not getting his money back due to financial problems within Praxis. Amicore lost the backing of MS and are not currently taking on new customers. They are in the midst of a restructuring. I did a whole slide on this inside the EMR presentation that I gave last year, downloadable at http://www.emrupdate.com/files/folders/al_borges/entry54223.aspx .

joseph

Greetings;

RE: issue of weeding out companies. I dont think it is right. We are running office -paperless for 2 1/2 yrs already using an EMR (non certified per choice of owner-doctor, and rightly so). And so are 1000 of other doctors and hospitals. Though nobody is forcing me to buy certified one or even certify, the issue about introduction of CCHIT is : in future Govt, Insurances, Liability insurances, P4P payers will start demanding certified EMRs. As I have explained in the thread:
http://blogs.bsti.com/healthcare/?p=419
it is just a matter of time before every payer clamours for CCHIT status.
So the ones who are already using EMRs successfully would be forced to change to certified ones, but that is not needed as we are successfully using EMR already.

Re: New users and adoption, though when there are 400 companies to choose from, it may be confusing to choose one, it does not mean an agency should be created to weed out the process. There are a lot of ways to choose an EMR, not by artificially culling the herd as seems to be the role of CCHIT and improving the market share of big EMRs.

Regards

William Bryson

Joseph,

I haven't had the opportunity to view all the links you put out there (I will, I promise) but right off the top I'd say this: I think my argument was to let the market figure it out. I think that CCHIT standards serve the purpose you propose: "First establish the standards, publish the standards on internet, let EMR vendors write software conforming to standards." No one is being forced to certify; no one is being forced to buy certified product. That's the market at work. If doctors prefer not to buy CCHIT certified EHR then the force of their buying power will have spoken. If, however, doctors find that the CCHIT certification helps them to better weed out the 400+ EHR vendors out there, that's fine, too. I'm going to stop there until I've had a chance to review the material you sent along. If this preliminary attempt to clarify our position leaves you cold, please do post again. I always want to learn more through exchange of ideas!

joseph

So you are saying big companies are rock solid and will stay for ever. Heard about Pan am?

Leave it to market forces. First establish the standards, publish the standards on internet, let EMR vendors write software conforming to standards. CCHIT does not have interoperability critieria, they want to add some every year. See the article:http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20061030/FREE/61030014&SearchID=73261927988724
But they already have started certifying for the fee. It is just not the fee, it takes $200,000 for vendor to reassign the programmers to change the direction of company and manpower. See article:
http://www.medsp.com/ehro/market_drivers/ehro_mrkt_trends.php

We have a lot of discussion about CCHIT at
http://www.emrupdate.com/forums/42/ShowForum.aspx
CCHIT will make a million dollars in first 6 mths.See thread: http://www.emrupdate.com/forums/thread/57822.aspx

Regards.

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