- Epic EHR and other competing EHR technology once again dominated the health IT headlines this year, alongside major policy moves such as the MACRA implementation final rule and Stage 2 Meaningful Use attestation.
This year, policymakers unveiled the awaited MACRA implementation final rule, presenting a new set of quality benchmarks for providers to meet going into 2017. Alongside MACRA implementation comes meaningful use, with some providers having attested to the Stage 2 this year and preparing for the optional Stage 3 start date in 2017.
All of that happened amidst a flurry of vendor news, specifically focused on Epic Systems, known for their significant market dominance and rumored issues with health data interoperability.
Below, EHRIntelligence.com takes a look back at the ten most popular health IT and EHR-related stories of 2016.
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Health policymakers shook up the industry this year first when it issued the proposed MACRA implementation rule, and next when it finalized the rule this past October.
For EHR users and technology developers, the MACRA implementation rules introduced a vast set of EHR requirements. Under the Merit-based Incentive Payment System (MIPS), eligible clinicians must attest to a set of quality benchmarks and adhere to a set of provisions similar to meaningful use.
EHR developers are now seeing a significant incentive to meet provider needs, aiding them in successfully participating in the MACRA rule. For example, eligible clinicians are required to use either 2014 or 2015 certified EHR technology (CEHRT). Additionally, participants will rely heavily on application programming interfaces (APIs) to allow for smooth transmission of health data.
Although aggregated nearly one year ago, healthcare professionals remained interested in the largest Epic EHR implementations across the country.
Epic is a well-known technology used in several large health systems, including Kaiser Permanente Health System, Providence Health & Services, and University of Pittsburgh Medical Center. The technology has helped those institutions earn various accolades such as Davies Enterprise Awards and HIMSS Level 7 awards.
Epic EHR and interoperability news is always notable, and becomes even more so when the company’s CEO, Judy Faulkner, goes on the record to discuss the topic.
At the annual HIMSS Conference and Exhibition, Faulkner sat down with EHRIntelligence.com to discuss the company’s patient portal and interoperability capabilities.
According to Faulkner, the company has allowed for deeper information across the portal, called MyChart, over the past year.
“In the past, if you had two MyCharts from two different Epic providers, you’ve had two different MyCharts, Faulkner explained. “You can use a single sign-on for them, but the charts have been separate. And if you have another vendor’s patient portal, you have three different portals, and so on.”
“We have now changed MyChart so that everything is all together no matter how many iterations of the portal you have – or if you have a portal from other vendors,” she announced. “So you, as the patient, can see all your appointments, no matter where they’re from, and all your meds and everything else all together, which is very neat.”
Faulkner also acknowledged the industry chatter surrounding Epic’s interoperability.
“I think that we do, by far, the most interoperability that any group does, and it should be reported so that others can see how much interoperability there truly is,” she said. “Right now, it’s hidden, and there’s nothing but innuendos about it.”
The interest in EHR vendors and large-scale implementations continued, this time with Cerner Corporation, another vendor with heavy market share.
Cerner has been responsible for EHR implementations at several large health systems and hospitals across the country, and has helped those institutions earn industry recognitions for exemplary EHR use.
This was one of the first inklings CMS officials gave that they would end the meaningful use program for eligible providers going forward. At the 34th Annual JP Morgan Healthcare Conference, CMS Acting Administrator Andy Slavitt made the following announcement:
“The CMS meaningful use program as it has existed will now effectively be over, and replaced with something better,” Slavitt said.
“Since late last year we’ve been working side by side with physician organizations across many communities, including with great advocacy from the AMA and have listened to the needs and concerns of many. We’ll be putting out the details of this next stage over the next few months, but I’ll give you a couple of themes that are guiding our implementation.”
Eventually, CMS’s plans to revamp meaningful use for eligible professionals (now called eligible clinicians) came to fruition with the MACRA implementation proposed rule, which integrated aspects of meaningful use into the Merit-based Incentive Payment System.
Physician burnout was a trending topic in the healthcare IT space this year. EHRIntelligence.com spoke with Steven J. Stack, MD then-President of the American Medical Association, to understand how to curb provider lethargy in the high-demand field.
"Doctors will get behind things that support better quality of care and support them in their clinical practice. It's the nonsensical stuff that makes it infuriating and challenging," Stack said.
"When we are going to get adverse consequences to ourselves or hospitals by complying with the current thinking in medical treatment rather than outdated quality reporting and regulation, those sorts of things are good examples where regulation is not a good tool at times to try to keep up with the fast pace of medical innovation, and good intentions can lead to undesired adverse consequences."
Although this article was published nearly three years ago, healthcare professionals are still grappling with Epic’s allure over other EHR vendors.
In a blog post, Beth Israel Deaconess Medical Center CIO Jon Halamka, MD, explains that Epic Systems offers an all-inclusive suite of products, streamlining health IT use for providers and technology professionals. Additionally, the vendor offers a strong system for meaningful use, a significant regulatory burden occupying the minds of providers in 2013 and today.
In October, 2015, CMS issued the final rule for Modified Stage 2 Meaningful Use. With these modifications came the streamlining of redundant or outdated measures.
In 2016, eligible professionals needed to attest to 10 core objectives, one of which being an overarching public health reporting measure.
Modified Stage 2 Meaningful Use also streamlined the process for eligible hospitals and critical access hospitals, reducing the number of core objectives to nine with an overarching public health measure.
Under the final rule, all eligible providers were required to use at least 2014 edition CEHRT.
The end of meaningful use for physicians was a widely anticipated announcement after CMS Acting Administrator Andy Slavitt alluded to it at the JP Morgan Healthcare Conference.
This announcement came along with the draft rule for MACRA implementation. The draft explained that eligible professionals, now called eligible clinicians, were to attest to meaningful use-like requirements under the Merit-Based Incentive Payment System, a portion of the Quality Payment Program and MACRA implementation.
Specifically, meaningful use was streamlined and integrated under Advancing Care Information, one of four category measures contributing to MIPS.
“We’re proposing today to replace meaningful use in the physician office with a new effort that moves the emphasis away from the use of information technology to one that support patient care supported by better and more connected technology,” Slavitt said following the draft rule’s publication.
For the sixth year in a row, Epic Systems brought home the Overall Software Suite award, the Overall Physician Practice award, and seven Best in KLAS awards.
These included high scores for patient portals, health information exchanges, and acute care EHRs. The vendor also scored top honors for its applications in surgery management, patient accounting and patient management, ambulatory EHR, and practice management.
Much of this news is likely to stay relevant going into 2017. Eligible clinicians are set to begin reporting to the Quality Payment Program at the start of the New Year. And as they face requirements to adopt 2015 edition CEHRT, vendor news is set to remain at the forefront.