In this Industry… 1. Anything Is Possible… 2. Given Enough Time and Money

I have recently been amazed at how often #1 is put forward and #2 is ignored. 2011 will prove to be an interesting year, and I am going to make a prediction that with the products that currently exist in the marketplace, no more than 50% of medical practices planning to capture meaningful use payments will actually do so. I am also going to predict that over 80% of EMR/EHR purchased in 2010 and 2011 will fail to receive meaningful use bonuses. Practices simply will not have enough time and/or money to carry through. It is my perception the bulk of recent purchases have been (and are currently) to acquire golden spoons for situations where backhoes are needed.

The sad realities are that, increasingly, purchasing and implementation decisions are being made by entities that really do not adequately understand the monsters associated with comprehensive EMR use. The persisting naiveté regarding what is needed at the point of care is nothing less than astonishing.

There simply is not enough time or labor available to dig foundations with spoons, no matter how expensive and “golden” the spoons might prove to be. As a result, I predict that there will be a lot of chaos and inconvenience for the majority of physicians that have recently taken, or are in the process of making, the EMR/EHR plunge. There will even be more chaos and transition at the CIO/CMO level, and in the EMR/EHR vendor world, when expected deliverables are not forthcoming.

It is also a sad reality that sources of information often used to assist in EMR/EHR selection and implementation are often misguided. For example, one of the most prominent vendor ranking/survey entities recently gave an acropolitic, 100% positive ranking to a vendor who has practically no significant, successful EMR/EHR implementations within busy practices. Look for this particular EMR/EHR vendor to sell out to an acquirer in late 2011 or early 2012 which will likely deliver immunities to their principles who have been unconditionally promising meaningful use reward payments to their customers. Also, look for this ranking company to continue, unabated, in their tradition of ranking many products at the top that will continue to have a greater than 50% failure rate. This has been the pattern for the past decade, and some things predictably don't change.

Another recent EMR/EHR survey included, as their top, recommended vendor, one who has only met 40% of the requirements for meaningful use, so it is only a “modular” rather than complete EHR system. Users of this “free” system currently have little probability of actually receiving meaningful use payments. Will this vendor be able to get enough, additional venture capital money (or ad sales?) in time to force cold fusion? Realistically, even if they do successfully add the necessary functionalities, the cumbersomeness of using this system to actually capture and report the data from the point of care is most likely to be more daunting than practical.

It is anyone's guess what will happen to some of the REC entities who are so prominently promoting golden spoons? Will they be allowed to fail, or will the taxpayers be pleased to come to their rescue?

So, for the next year, I predict somewhere north of 50% of medical practices will not have either the time, energy, or the money to persist in their currently misguided EMR/EHR purchases and implementations. We hope to be an exception to the norm. It is our goal for no less than 90% of SOAPware users who intend to receive meaningful use payments be successful in doing so. Rather than being focused on making promises, out of context, to potential purchasers, we are mostly focusing on assisting our users properly implement our software and see that they properly submit their attestations to the ONC. More to come on both of these key issues. It is our sincere intent to accomplish this in fashions that actually improve the well-being of patients and the doctors deserving of their trust.