As an EHR vendor, Amazing Charts CEO Jonathan Bertman MD says he fully supports the government’s push to digitize health records. As a physician and taxpayer, however, he’s concerned about the way the initiative is being undertaken, particularly when it comes to the efforts of Regional Extension Centers (RECs) charged with providing, training and supporting small physician practices as they implement EHRs.
Bertman, whose Rhode Island-based company offers prospective buyers a 3-month free trial of its product before buying the system at a cost of $995, is calling on RECs to provide a greater level of transparency.
“I think the RECs need to be completely transparent about who’s making the decisions about what products to recommend to physicians, how those decisions are being made, and the credentials of the people making the decisions. For example, how many of the committee members actually work in small practices?”
Based on demonstrations his company has done for RECs, Bertman has his own ideas about who is serving on the REC selection committees. “I suspect that the people on these committees are from payer organizations or from quality institutes – people who are focused on getting the data they need, not on whether or not the physicians can actually use the systems. I don’t know this for sure, though, and that’s why I’m pushing for greater transparency.”
As federally funded entities, RECs have received approximately $600 million to provide outreach and services to at least 100,000 primary care physicians over the next two years.
As of last month, Amazing Charts had responded to 17 Requests for Information from RECs across the country. Amazing Charts, whose product is in 3,600 unique practices and growing by an additional 70 practices a month, didn’t make the final cut of any of the seven RECs that have released their preferred vendor lists.
Bertman says that in itself wouldn’t be remarkable except that in studies conducted by the American Academy of Physicians and Medscape’s Business of Medicine, Amazing Charts is consistently rated higher in usability and affordability than many of the EHRs that were selected by the RECs – the two primary criteria that the RECs are supposed to be basing their choices on.
“Most of the solutions chosen by the RECs cost tens of thousands of dollars to implement and maintain,” he says. “The EHR products they’re choosing, many of which have been designed for hospitals and large group practices, are inappropriate for small practices. Yet the RECs continue to choose these products again and again.”
Bertman adds that the real danger is that the small providers who are relying on the RECs to help them make EHR purchase decisions will buy prohibitively expensive products that are overly complex, thereby reducing their chance of adoption success.
“What it looks like to me is that the people on the RECs’ preferred vendor selection committees are enamored of fancy sales presentations, which show all the products’ bells and whistles, but not true functionality or usability,” Bertman says. “I don’t think RECs understand how to select EHR systems that doctors can actually use.”
Sour grapes on Bertman’s part?
“While I’m disappointed that Amazing Charts wasn’t selected by these RECs, the larger issue is that there is something wrong with a process that closed to public scrutiny,” he says.
While Bertman is concerned about the lack of transparency in many of the RECs decision making processes, he has seen signs of vendor neutrality among a handful of RECs.
“There are a few RECs, namely those in Oklahoma, Nebraska, and Texas, that don’t have a preferred vendor selection process and to me, that’s the fairest approach. Those RECs evaluate and present to health care providers any EHR vendor that submits an RFI and meets the criteria. The whole concept of the RECs was to have a vendor-neutral stance,” he says.
Based on what he’s seen, Bertman’s forecast for the next few years is dim. “If I take a step back and think about what will happen in the next five years, I think that there will be a lot of implementation failures.”
Bertman believes that the stakes are particularly high for small practices. “Small practices are going to take the recommendations that the RECs make and unfortunately, they’re recommending products that for small practice physicians, just aren’t rated high in usability. To break even in a small practice, a doctor needs to see 20-25 patients a day. If they have a clunky system, the notes don’t get done and it defeats the entire purpose.”
In making decisions about what products to recommend to physicians, Bertman urges RECs to look at the usability. “People should decide what the best products are based on the evidence. Products like Amazing Charts are affordable and usable. We don’t have the bells and whistles of the big boys, but what’s consistently been shown in usability studies is that it’s the bells and whistles that often make the products less usable.”
While we have contacted several RECs across the country to get their responses to Bertman’s call for transparency, at the time of this issue’s printing, none had replied. We hope to bring you additional information in the next issue.
Copyright 2010 Algonquin Professional Publishing, LLC