Healthcare Informatics Editor-in-Chief Mark Hagland spoke on March 13 to Carl Dvorak, the number-two executive at Epic Systems Corporation, the Verona, Wis.-based vendor organization. Dvorak, who started with Epic back in 1987, and who had been executive vice president for a number of years, this month was given the title president. Judy Faulkner, co-founder and CEO of Epic, retains her title. Dvorak spoke exclusively with Hagland regarding the latest developments around the CommonWell initiative announced at HIMSS13, and other issues. Below are excerpts from their interview.
Congratulations on your title promotion.
Is there a special significance to the announcement?
No, not really; it’s really just a natural progression.
Given the very forceful statements from Marilyn Tavenner, R.N. [acting administrator of the Centers for Medicare & Medicaid Services (CMS)] and Dr. Mostashari [Farzad Mostashari, M.D., national coordinator for Health IT and head of the Office of the National Coordinator for Health Information Technology (ONC)] during the HIMSS Conference last week in New Orleans, what are your general thoughts about CMS and ONC, and the level of intensity of change they’re asking from the industry?
There are a couple of key drivers going on right now, and one is still [the transition to] ICD-10, and clarity and certainty are very important right now around that. Many of our customers had set up all their deadlines and timeframes around the original deadline, but when that was pushed back, the laggards were rewarded and the proactive people were penalized. So that created an uncertainty. I met with Marilyn Tavenner the morning before she gave her speech [Wednesday, March 6], and she assured me that ICD-10 will not move, and that it will be payers and providers together, not staggered.
So you felt better about being reassured?
What’s your perspective on the CMS/ONC announcement, first made by Ms. Tavenner and then confirmed immediately afterwards by Dr. Mostashari in a press conference, that they’re delaying the release of the preliminary rule for Stage 3 of meaningful use until after the end of calendar year 2013? Do you see that as a positive or negative development?
It’s reasonable not to regulate ahead of understanding; and I think we were beginning to see ONC beginning to regulate ahead of their understanding. That said, I want to emphasize the minimum 18-month timeframe needed to comprehend the standards and regulations, get through the FAQ process, design usable, elegant software that can help enhance clinical practice and not detract from it, and give time for customers to implement and upgrade the software. And if you’ve got 1,000 doctors in your practice, you’ve got to give them time to implement. So while I think it’s wise not to publish regulations in haste without understanding, at the same time, it does not give them carte blanche [at ONC/CMS] to foreshorten the time needed to accomplish things.
So they’d have to extend the deadline at the back end, then?
Or, the alternative would be just to extend the percentages around compliance.
Though they’re saying there will be new requirements under stage 3?
Yes, inevitably; I think it’s a question of how many new requirements, and of the balance.
What’s your reaction to the announcement of the creation of the CommonWell Health Alliance during HIMSS13? Many viewed it as a competitive maneuver, especially since you were not contacted beforehand about it, at Epic.
There are a lot of elements to it. A couple of things: I know Neal Patterson [CEO of the Kansas City-based Cerner Corporation] has personally championed the notion of a single national patient identifier; and we support that as well; we think that’s a good thing. At the same time, we believe that you can be very, very successful with interoperability without that. And in today’s world, we’ve pretty much concluded that folks like [the Arlington, Va.-based] SureScripts are doing a pretty good job based on collecting demographic information and using the last four digits of the Social Security number. So we’re supportive of that concept.