There's plenty of time to install a client-server EMR, but MU rules remain ambiguous

Given the relatively short timeline for achieving "meaningful use" of EMRs, some have suggested that software-as-a-service is the only way to go for physician practices that haven't started implementing a system yet. John Lynn, a hospital tech-support professional who writes the EMR and HIPAA blog is not among this crowd.

"First, there is still plenty of time for a clinic to implement an EMR of any type and get EMR stimulus money. At some point this might change, but at this point we are still far enough out that time is not an issue," Lynn writes in a post this week."You just better make sure you have the right IT people supporting your implementation" if it's a client-server product, he adds.

What really would help providers of all types, Lynn argues in another post, is some more clarity on the rules. "I'm still really disturbed by the fact that we have so few practical meaningful use details. Sure, we have a lot of guidelines and a lot of prognosticators guessing at what they mean and how they'll be measured. We even have a certifying body trying to guess what the EHR certification will be. Sadly, they're all still guesses," he says.

For example, the requirement that providers write at least 75 percent of "permissible prescriptions" electronically sounds rather simple. But what does "permissible" mean? Right now, it's illegal to e-prescribe controlled substances, but the DEA is lifting that restriction on June 1. Those with e-prescribing now have to run parallel systems, using paper whenever a controlled substance is involved. "Will doctors then be required to flip a switch and start sending controlled substance prescriptions electronically as well? Once they're allowed, they'll be considered permissible, no?" Lynn wonders.

"Also, does it give anyone else a bit of angst that the EHR software is basically going to spit out a report saying, 'Yes, I e-prescribed 75 percent of my prescriptions?' I'm not sure how you scale a more sophisticated solution, but just taking some report from an EHR seems plenty gameable to me," he adds.

For more:
- see Lynn's post about SaaS EHRs
- discover his thoughts about e-prescribing provisions of meaningful use
- read this Government Health IT update on the DEA rule