Health IT software – and EHRs in particular – are widely criticized for their inefficient workflows and unfriendly user interfaces. Unhappy end-users may blame EHR vendors for failing to deliver great software, perhaps not realizing that health IT companies struggle to balance limited financial and human resources and must choose between meeting ever-changing regulatory demands and creating innovative updates that improve the user experience.
Consider this: every year, vendors must make dozens of updates to comply with regulations from federal and state governments and private payers. Instead of enhancing their solutions to address user demands and preserve their competitive position in the market, health IT companies are forced to invest significant capital and R&D manpower to satisfy new billing and reporting requirements and updated standards. Such updates are essential and ensure providers have the proper tools to secure incentive payments and accurate reimbursement. But the cost to innovation is high.
EHR vendors want to produce great software and deliver an excellent user experience. Unfortunately, most organizations can’t deliver all the innovative updates users demand because they are struggling to keep up with the high volume of high-priority regulatory updates.
SCRIPT17: The Latest Regulatory Requirement
One of the latest mandated industry standards is NCPDP SCRIPT2017071 (SCRIPT17.) SCRIPT17 affects prescribers and is designed to improve patient safety, clinical decision-making, and administrative efficiencies. Beginning January 1, 2020, all electronically submitted prescriptions are required to use a certified and viable e-prescribing solution that complies with the SCRIPT17 standard.
While SCRIPT17 is expected to close some quality and efficiency gaps within the current electronic prescribing process, its implementation will require yet another heavy lift from EHR development teams. The new standard is possibly the largest and most costly mandated prescribing change that health IT companies have ever faced – and the January 1, 2020 deadline is rapidly approaching.
EHR vendors are used to re-prioritizing R&D activities each time a new standard or regulation is introduced. For example, the escalating abuse of opioids has forced vendors to update their systems any time the federal government or individual states implement new rules for the electronic prescribing of controlled substances. Over the years, vendors have juggled R&D priorities to develop updates for NCPDP standard revisions (8.1 and 10.6), 270/271 eligibility requirements, Meaningful Use, and numerous other programs designed to improve the scalability and security of systems.
State-specific prescription monitoring programs such as New York’s iSTOP and California’s CURES add additional complexities for vendors. No sooner than a vendor releases an e-prescribing update to satisfy one state’s prescription drug monitoring program (PDMP) requirements, another state will implement its own set of rules, requiring additional e-prescribing updates.
In addition to ever-evolving e-prescribing rules, EHR companies also must consider the impact of value-based payment models and complex reporting requirements for CMS’ Quality Payment Program, plus data tracking requirements for the new Promoting Interoperability program. With the continuous flood of new mandated standards and regulations, it’s a wonder that EHR vendors have remaining resources for any innovation efforts.
To more effectively manage R&D priorities and free resources for innovation initiatives, more and more EHR vendors are outsourcing portions of their development work to third-party vendors.
Lightening the R&D Load with Outsourcing
EHR vendors seeking to lighten their R&D burdens should consider the advantages of outsourcing the e-prescribing function. Electronic prescribing is an essential EHR function but keeping current with e-prescribing regulations and standards is expensive and time-consuming.
Some key reasons that e-prescribing is an ideal outsourcing candidate include:
1. The Surescripts certification process has largely standardized the flow, content, transactions, and even the look and feel, of the e-prescribing function. Seldom, if ever, are e-prescribing features a competitive advantage for an EHR.
2. Pharmacy-related functions are highly regulated to prevent diversion and abuse; they are also subject to trading partner requirements to minimize friction in their processes. Because regulations are constantly updated, e-prescribing code must be continuously updated as well. Over time the numerous changes can negatively impact the overall functionality of the e-prescribing module.
3. EHR vendors seldom have time to add sophisticated new features to e-prescribing, but vendors who specialize in e-prescribing do.
4. Several vendors in the e-prescribing space offer award-winning services and capabilities, have the time and resources to invest in regulatory and industry compliance and provide the opportunity to spread development costs over a broad set of clients.
Advantages of Outsourcing E-prescribing
Hundreds of EHR vendors are currently outsourcing the e-prescribing function and recognizing benefits such as:
– Additional resources for innovation. When e-prescribing elements are outsourced, EHR vendors can focus their development efforts on innovations that bolster their competitive advantage. In the highly competitive and saturated EHR market, innovation is the key to long term success and survival. Rather than divert human and financial resources to satisfy the latest regulatory requirements, vendors can dedicate resources toward strategic initiatives to maintain and grow market share and differentiate their solution in the eyes of buyers.
– Increased focus on core competencies. EHR vendors, like all stakeholders, place a high priority on patient safety and health outcomes. This commitment to safety and quality outcomes is one reason EHR vendors comply with the latest regulations and standards. Remaining current with e-prescribing’s complex and changing regulations, however, consumes a disproportionate amount of a vendor’s resources for a relatively small, albeit essential, piece of EHR functionality. When e-prescribing is outsourced, vendors can increase their focus on initiatives that leverage their core competencies.
– Peace of mind. While most EHR vendors have solid development teams, some organizations lack in-house experts with the unique domain knowledge required to address complex e-prescribing regulations and the intricacies of the certification processes. A partner with deep e-prescribing expertise has the resources to rapidly build, monitor, update and support the platform. EHR vendors – and their clients – can rest assured that all required updates will be implemented by the mandated deadlines. With the right innovation partner, vendors can remove friction in EHR processes, deliver prescribers advanced insights that support improved patient outcomes, and take advantage of new revenue streams that support business growth.
EHR vendors will need to allocate significant human and financial resources to ensure compliance with the SCRIPT17 standard by the January 1, 2020 deadline. With more regulatory mandates on the horizon, it’s an ideal time for health IT companies to consider partnering with an e-prescribing expert – and free their limited resources to focus on EHR innovation.
About G. Cameron Deemer
G. Cameron Deemer is president of DrFirst, the nation’s leading provider of e-prescribing, price transparency, and medication management solutions.