What about the Complete EHR-Versus-Modular-Technology Conundrum?

Ganiban: I think some vendors are taking advantage of the complete EHR certification to require customers to purchase their entire system, even though ONC and HHS have indicated that you just have to ‘possess’ a certified complete EHR or a bundle of certified modules that together would provide all of the required certified functionality. . .In the response to FAQ 12-10-21-1, the regulators say “We consider ‘possession’ of certified EHR technology to be either the physical possession of medium on which a certified complete EHR or combination of certified EHR modules resides, or a legally enforceable right by an eligible health care provider to access and use, at its discretion, the capabilities a certified complete EHR or combination of certified EHR modules includes. An eligible health care provider may determine the extent to which it will implement or use these capabilities, which will not affect the provider’s ‘possession’ of certified EHR technology. While we recognize that eligible health care providers may enter into various business arrangements depending on their particular needs and circumstances, we would expect that such arrangements could potentially include agreements with EHR technology developer(s) to access and use the capabilities included in Certified EHR Technology. Further, that these business arrangements could make an eligible health care provider’s payment for a particular capability contingent on its use or implementation of that capability in a production environment or the provider’s request for maintenance or technical support...”

HCI: In other words, some vendors are taking advantage of remaining ambiguities around the term ‘possession,’ and what it really means.

Ganiban: Yes, it seems so, so one needs to understand these nuances.