Will a "lite EHR" fly with physicians?

Inexpensive EHRs like Amazing Charts and SOAPware continue to appeal to small practices, despite their lack of CCHIT certification. And some vendors with mid-priced, certified products are now putting out simpler versions of their EHRs to compete in that market segment. Among them are e-MDs, which plans to release a "lite" version of its system in the fall, and Spring Medical Systems, which sells its SpringCharts Essentials EHR for about $2,500, half the price of its full-featured product. Both of these EHRs can be upgraded to the vendors' certified products without changing the database that contains patient data.

Jack Smyth, president and CEO of Spring Medical Systems, supports the concept of EHR certification. But he says that some of the requirements involve features that small practices don't need and that can even disrupt their workflow. For example, he notes that the "high-security" features may be fine for large groups and hospital systems, but just get in the way of physicians in small practices who have to keep re-entering complex passwords that must be changed every 60 days. Moreover, he says, some of the functions required for certification significantly increase the cost of EHRs.

He proposes that the Certification Commission change its approach in one of two ways: either create different paths to certification for products designed for small offices and large groups, or state that a "lite" EHR is upgradable to a certified product. The latter approach wouldn't cost CCHIT anything, he says, and it would allow vendors to assure physicians who want a certified product that they could upgrade to one later.

In Smyth's view, a usable lite EHR includes such basic functions as longitudinal electronic charts, past medical histories, medication lists, a prescription writer, and the ability to receive lab results online. But it doesn't have alerts and reminders, drug interaction checkers, or other expensive bells and whistles.