New numbers from the Office of the National Coordinator (ONC) show that for the 2014 program year of meaningful use, most eligible hospitals (EHs) and eligible professionals (EPs) achieved sufficient EHR integration required for attestation. For both groups of providers, large numbers obtained 2014 Edition Certified EHR Technology (CEHRT) from their current EHR vendor for attesting to the 2014 definition of meaningful use.
Dustin Charles, public health analyst at ONC, delivered the figures during the Health IT Policy Committee meeting on Sept. 9. “We found that for hospitals, 90 percent of them at the beginning of the 2014 meaningful use program year could obtain 2014 CEHRT from their current vendor. Then, by the last date that they could begin their attestation period for 2014, 98 percent of hospitals could get their 2014 CEHRT from their current vendor.”
Charles continued, “We ran the same analysis on EPs, and we found that 77 percent could get 2014 CEHRT from their current vendor at the beginning of their meaningful use period. And then, by the end [of the period], 94 percent could do it.”
Although EPs lag behind EHs in this measure, Charles said it’s important to consider that there are hundreds of thousands of EPs in the meaningful use program, compared to just several thousand EHs. Also, the EP vendor base is much more diverse with nearly 600 total EHR vendors, compared to about 150 for EHs.
ONC also looked at providers who used the Flexibility Rule, which allowed some providers to continue to attest in 2014 using a 2011 Edition product to meet the 2013 definition of meaningful use attestation. Again, most had a 2014 CEHRT option available from their current EHR vendor.
“We found that [using the Flex Rule], 96 percent of hospitals and 89 percent of professionals could obtain their 2014 CEHRT from their current vendor,” explained Charles.
However, that same finding indicates that 4 percent of hospitals and 11 percent of EPs still needed to get a product or products from a different EHR vendor for 2014 attestation. “This could mean they might need to do a complete ‘rip and replace’ — or maybe they just need one or two products from a different vendor. It’s also possible that their EHR vendor couldn’t pass 2014 CEHRT between [the start of the program year] and the next attestation,” said Charles.
ONC also compared the approaches that hospitals and professionals took get their 2014 CEHRT. For EPs, 16 percent made a change to their EHR vendor in the 2014 program year, compared to just 5 percent in 2013 and 4 percent in 2014. About half of the 2014 EPs who switched vendors went the rip-and-replace route, while the rest kept their original vendor but added or dropped an EHR module. For hospitals, a “striking” 40 percent made at least some change in EHR vendor, according to the analysis. However, only 4 percent of the hospitals who switched vendors did a full EHR replacement; most of the rest kept their old vendor while adding a new module from another vendor.
HITPC members questioned whether ONC looked into the cost of EHR replacement for those providers who decided to tear out their old systems. ONC currently does not have cost estimates available, noted Charles. “There are many reasons why providers want to change their own vendor,” he said. “We looked at this mostly from the certification perspective ... We would like to look more into who did switch and understand what’s going on there.”
Another committee member wondered whether the numbers could be interpreted to show increasing dominance by larger vendors — and possible attrition among smaller vendors who reportedly have had great difficulty certifying their products for the 2014 Edition.
Specific vendors weren’t filtered out in the current analysis. “We wanted to understand the overall market. But we do want to look at attrition rates, and that’s something we’ll look at in the future,” said Charles.
“The data is available online,” he added. “If anyone wants to run their own analyses, they can get that information.”