Who watches the watchers?
In a world where the majority of practices depend on electronic health record systems to care for patients, we also depend on the companies that make them. After all, the main (if not only) reason most practices jumped to them was to qualify for meaningful use payments.
In buying them, we’re trusting that the manufacturer is doing its best to keep them updated, operational, and compliant, right? Beyond people’s health, there’s also a lot of money at stake here.
Then, in May, eClinicalWorks (an EHR vendor commonly used by neurologists), settled a $155 million lawsuit with the federal government.
The alleged bones of the matter is that eClinicalWorks knowingly misrepresented its software to get certification in the EHR incentive program. The U.S. Department of Justice says the program was modified to retrieve only specific drugs and didn’t reliably record certain chart information (such as orders and drug interactions) or allow patient information to transfer to other systems.
I should note that, in settling this matter, eClinicalWorks did not admit wrongdoing. The company just agreed to pay that money to close the lawsuit.
Guess what? If your practice used eClinicalWorks, you’re no longer in compliance. So you could be penalized, too. Fortunately, the Centers for Medicare & Medicaid Services has recognized this and announced that practices won’t be held responsible for the vendor’s failings.
Perhaps eClinicalWorks meant no harm by these things. I understand that. Projects like this are complex. It’s easy for things to fall behind and slip through the cracks. With any software release there are always issues that aren’t recognized until it comes into widespread use. But this is patient health, not the latest version of Flappy Bird.
More worrisome is the other possibility: that eClinicalWorks was aware of the issues and covered them up so as not to affect sales. If this is the case, the company made a conscious decision to choose money over patient safety.
We’ll likely never know.
In its defense, eClinicalWorks states that most of these issues have been fixed, and the others are being actively corrected and tested. The company has agreed to do quality control oversight and to track, publish, and correct problems as they become apparent.
A decision many practices face now is whether or not to stay with the company. Can you trust eClinicalWorks from here on out? If so, how vigilant do you need to be? If not, how much time and money will a new EHR system cost to implement?
Not an easy choice for any practice trying to stay afloat these days.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.