As providers gear up to go after government incentive payments for meaningful use of electronic health records, there's been a nagging fear that vendors won't be able to increase staff and other resources quickly enough to meet demand. That's a legitimate concern, says Charles Christian, director of information systems and CIO at Good Samaritan Hospital in Vincennes, Ind.

"What others expected, we're already seeing as their resources are strained," he adds. The hospital is implementing practice management and electronic records software, which it will host for owned practices, from Chicago-based Allscripts. The hospital has about 25 physicians in 10 owned practices and expects that to double by next summer.

Christian acknowledges that he's likely part of Allscripts' problem. "They're hiring as fast as they can but I'm not willing to be a training ground." Consequently, Christian hired his own implementer and is looking for at least one more. They will work with Allscripts and form the backbone of the hospital's physician support organization. Good Samaritan's new employee implemented EHRs in physician offices for two-and-one-half years at Cerner Corp., but wanted to come back home "and we scooped him up," Christian adds.

There are and will be resource challenges for vendors, acknowledges Glen Tullman, Allscripts CEO. "The best advice I can give to people is to get in line as soon as you can." Once physicians start seeing peers get incentive checks, there will be more coming in, Tullman says. "We've been hiring for the last year and will be continuing to hire to meet demand."

Mark Segal, vice president of government and industry affairs at the information technology unit of Waukesha, Wis.-based GE Healthcare, echoes that advice.  GE has worked to speed upgrades and deployments to stay ahead of the implementation curve, he notes. "But if you really want to do something in 2011, you ought to be in line now."

That said, it is difficult for vendors to really know what the demand for their services will be, Segal says. Sales are up this year, but GE didn't see the sharp response it expected because many questions remained for providers as seven months passed between the proposed and final meaningful use rules.

Tullman contends all major vendors will meet or exceed EHR certification requirements. Vendors have been preparing their systems to handle the proposed meaningful use criteria and there's not that much new that's required under the final rule, he says. "From a software perspective, that won't be an issue."

Vendors and emerging EHR certifiers have known since a proposed rule was issued in March how the EHR certification program will be developed, its test methods and criteria, Segal says. Consequently, they should be able to move through the process fairly quickly now that the certification rule is final, making the first certifications in September and October doable.

Meaningful use criteria, Segal adds, is less detailed, particularly in terms of workflow, than previous EHR certifying criteria from the Certification Commission for Health Information Technology. Overall, the new criteria are fewer in number and at a higher level. All the stars may not align in time for providers to start registering for the incentive program in January, but everything will work out during the year--and not everyone will start in 2011, he says.

Both vendor executives believe CCHIT, a known commodity, will have a "first mover" advantage among entities that become EHR certifiers under the temporary certification rule that will last until 2012. By the time the permanent certification program starts there will be a more level playing field, Segal says. For now, other entities selected by the government to be EHR certifiers will have to sell themselves to the industry.

Vendors in August can decide the EHR certification firm that they will work with and there will be strong immediate demand when the certifiers are up and operating, predicts Leigh Burchell, director of government relations at Allscripts. Asked if many vendors will go with CCHIT in the temporary program, at least initially, Tullman acknowledges that's likely. Vendors will want to go with a trusted source who has done EHR certifications and that certainly makes CCHIT a leader, but others may emerge, he says.

--Joseph Goedert

 

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