When it comes to Meaningful Use attestation, not all EHR vendors are created equal

Doctor typing on laptop
Researchers say wide variation among EHR vendors called into question the efficacy of EHR certification.

Whether it’s Cerner, Epic or a host of other EHR developers, the choice a hospital makes regarding its EHR platform has a notable impact on Meaningful Use performance.

In fact, EHR vendor choice accounts for 7%-34% of hospital performance variation in six Stage 2 core competencies, according to a study published in the Journal of the American Medical Informatics Association (JAMIA). That level of variation led researchers to question whether the federal government’s EHR certification process provides a baseline competency for all products.

“This suggests that the current EHR certification process does not achieve a key intended goal of giving providers confidence that they are buying a ‘good’ EHR,” they wrote.

Using attestation information from two federal databases and survey data from the American Hospital Association, researchers at Harvard, the University of California San Francisco and the University of Michigan discovered hospitals that used Epic performed particularly well on most core criteria. Of the 17 hospitals in the top performance quartile for five of the six core competencies, 15 used Epic. Nearly 65% of hospitals in the top quartile for four criteria used Epic, while just 12% used Cerner.

Epic performed particularly well when it came to satisfying requirements for computerized order entry and allowing patients to view, download or transmit their health data, whereas Cerner outperformed its competitors when it came to medication reconciliation.

The variation suggests vendors are “making different design choices,” the authors wrote, but some are doing a better job meeting Meaningful Use criteria.

“For hospital leaders, our study underscores the need to make careful choices when selecting an EHR vendor and offers some guidance on which products may be stronger,” they wrote. “In addition, our results may help hospitals make the case to vendors to improve their products.”

RELATED: eClinicalWorks settlement hints at broader certification infractions throughout the EHR industry

But the authors were also quick to point out that that vendor choice alone won’t translate to compliance. System implementation, IT staffing and EHR optimization represent extraneous factors that have a significant impact on meeting federal certification requirements. The researchers added that the data included hospitals that attested to Stage 2 prior to April 2016, which represented a small subset of early attesters.

For policymakers, the researchers called for a “broader and more rigorous approach to certification” that incorporates real-world data on EHR usability, rather than a narrow set of technical requirements. They specifically referenced the federal government’s $155 million settlement with eClinicalWorks earlier this year that described some of the inherent limitations in EHR certification.