Four tech trends in healthcare in 2017
Trend #3: Increased pressure on EHR vendors
Providers across the country are feeling that “their EHR vendor promised them the moon and delivered a rock quarry,” says Jodock. Still, she questions whether even the most successful EHRs can serve all the needs of today’s providers. Often, policymakers and healthcare industry leaders assume that the technology requirements in mandates such as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) can be supported through EHRs, but that’s not always the case, she says.
For example, not all EHRs can provide the level of reporting that’s required to support the meaningful use of pay-for-performance programs. In addition, inherent within changing payment models is the assumption that clinical and financial data can be shared among providers, she says. “EHRs don’t have the functionality to track these types of contractual arrangements or measure the percentage of responsibility any one provider involved in an episode of care should bear for the quality of care associated with that episode of care or the healthcare outcomes.”
While providers are increasing their adoption of alternative payment models, vendors are struggling to keep up with the type of functionality required to support the administration of these models. What healthcare vendors need is clear direction on how to build platforms that will support these new payment models, she says.
Morris, who once served as chief technology officer at MD Anderson Cancer Center, expects that MACRA requirements will mean that providers put additional pressure on EHR vendors to improve existing systems through improved work flow and software improvements (i.e., removing “bugs” from the systems). One specific area where providers will increasingly place demands on their EHR vendors is on functionality that will help them demonstrate quality and capability of embracing alternative payment models.
While in the past, the industry has witnessed the consolidation of EHR vendors, Morris anticipates that there will be less of this behavior. It was once common practice for a large EHR vendor to acquire a smaller specialty EHR that caters to gastroenterology, for example. Going forward, there’s a greater likelihood that the large EHR vendor will focus on developing this capability in-house.
While EHR vendors are facing more pressure from providers, providers are not necessarily in a position to invest more in EHR systems. Morris expects there to be modest investment in EHRs this year, as reflected in new sales reported by the major vendors in the third quarter of 2016.
Healthcare systems face a lot of uncertainty regarding the future of health insurance exchanges and the Medicaid expansion, which could impact patient cost-sharing responsibilities and patient volumes. Both could have a negative impact on healthcare systems’ finances, says Morris. As a result, healthcare CEOs and CFOs will likely wait to see what happens—and, in the meantime, they’ll conserve cash and not increase debt levels, which means fewer capital expenditures and less investment on EHRs.