EHR vendors have told their customers that their ability to innovate and to produce more usable, interoperable EHRs has been limited by their need to rewrite their software to meet changing EHR certification requirements. Only EHR technology certified by government-appointed firms can be used in demonstrating Meaningful Use.
Yet the end of “Meaningful Use as we know it” is unlikely to alter the EHR certification process, says Levinthal. Certified EHRs are required for PQRS, and they will be needed to show meaningful use in MIPS, she says. In addition, APMs will be required to use certified EHRs. And hospitals, which are not covered under MACRA, will still have to use certified EHRs to show meaningful use.
The alignment of EHRs with MACRA, Kibbe says, will probably occur in three areas: care coordination, patient engagement and quality reporting. All three will require interoperability, which Slavitt stressed in his remarks. But as Filer notes, the kind of innovation required for that and for other EHR improvements is not in evidence.
“We’ve offered to work with CMS going forward to cultivate a program that will improve quality and promote innovation in the next generation of EHRs, something that’s less clunky than what we work with today,” AAFP president Filer says. “Unfortunately, the Meaningful Use program seems to have almost put innovation on the back burner.”
Health IT could help lower cost and improve quality, “but we need the technology to work and we’re not there yet,” she continues. “So if there’s some way to hold vendors’ feet to the fire and say let’s work on innovation instead of penalizing us, that would go a lot further.”