The first quarter of 2014 is over and yet we are still witnessing EHR system vendors asking the government for more time, or to lessen the certification demands, for Stage 2 of the Centers for Medicare and Medicaid Services' meaningful use of EHRs program.

What's even more frustrating is that these vendors are asking their own practice customers for patience, while they figure out how to fix their own software or find the money to do so. Developers were given 16 months from the publish date of certification rules and yet many claim to still need more time to figure out how to modify their product.

This type of complaining is an outrage to the 80-plus EHR developers, as of mid-March, that invested significant resources in successfully earning Stage 2, 2014, certification for a Complete Ambulatory EHR system, in addition to the many vendors who were able to earn 2014 certification for inpatient EHR systems and other products.

What is occurring here, as we addressed in an article in this publication last year, "Thinning the herd: Why physicians will benefit from the mass consolidation in the EHR industry," is another shakeout among EHR companies. The demands of 2014 certification have proven too demanding and/or too expensive for the dozens of EHR developers who burst into the market for Stage 1 meaningful use. These organizations were eager to increase their bottom line and offered flashy sales presentations and promises, but with almost nothing to support their claims. Stage 2 forces these developers to face the facts and admit that they do not have any more options and are letting their practice customers suffer the consequences.

Industry consolidation

In the first "Thinning the herd" article, we described how the emergence of lean, cloud-based EHR systems with minimal monthly costs, lower training times, more responsive service and support was eliminating the vendors that offered bloated, inefficient software that disrupted physicians' productivity. 

While that was a market-driven industry consolidation, what we're witnessing now is largely regulatory-driven. The demanding requirements of 2014 EHR certification have developers realizing that their substandard products cannot easily be configured to support physicians with meaningful use Stages 2 and 3. These vendors are not focusing their attention and money on upgrading their product, they're instead complaining that 2014 certification requirements are too difficult to implement.

What's particularly concerning is that CMS recently expanded hardship exceptions for hospitals and eligible professionals if their EHR vendor hasn't earned 2014 certification. Despite this accommodation, some EHR software developers continue to complain about the meaningful use requirements.

Even if more exceptions are granted, practices should question if their EHR vendor is truly interested in their attestation success. These practices may need to explore the market for a company that can offer a complete system certified for Stage 2, and which is also easily customizable for the unique needs of their specialty. Practices should also select a partner that has a clear plan for how it is going to be certified for Stage 3 and for how it will support physicians with other emerging challenges in the healthcare industry, such as earning more revenue under value-based payment models.

Keeping promises

Earning 2014 EHR certification demands significant time, financial and personnel investment. Regardless, truly competent vendors need to continue to promise to all their physician customers they will always support them with certified technology if they choose to attest for meaningful use, without sacrificing the quality and usability of their EHR system – and always keep their promises. 

Easing 2014 EHR certification requirements, if that's the direction the government chooses, would only allow inept EHR developers and products to linger on the market, further disrupting practices' and clinicians' workflows and their ability to perform superior patient care. These more challenging requirements send a clear signal to practices about the type of vendors that they should seek out as partners and will strengthen the integrity of the developer community as these other entities fall by the wayside.

Michael Brozino is president and CEO of simplifyMD