One aspect of the meaningful use interim final rule that caught my attention was the forward-looking focus on certifying EHR modules as well as complete EHR systems. On Page 41, the Office of the National Coordinator for Health IT states: “We believe that it will be common in the near future for Certified EHR Technology to be assembled from several replaceable and swappable EHR Modules.”
ONCHIT’s leaders go on to compare the health IT marketplace to the market for consumer electronics, “where, for the purpose of setting up a home theater, a television, DVD player, and stereo system can be purchased from three different manufacturers, from a single manufacturer, or as a complete system from one manufacturer.”
They say a subscription to an application service provider for electronic prescribing could be an EHR Module and used to help meet the definition of Certified EHR Technology provided that the electronic prescribing capability the ASP enables has been tested and certified.
Some well-established vendors of legacy EHR systems probably don’t like the idea of moving toward plug-and-play interoperability with the components of lots of small competitors who may do one thing well. But I bet it is music to the ears of people like David Kibbe, MD, a senior advisor to the American Academy of Family Physicians.
Dr. Kibbe has been arguing for — and promoting — a grass roots movement toward modular, Web-based, and less expensive software for managing clinical work and information in medical practices. He calls this movement “Clinical Groupware” and is helping to form a new trade association, the Clinical Groupware Collaborative, to promote collaboration among its members. Executives of companies such as 4Medica, RMD Networks and VisionTree are represented on its board.
Will individual modules, Web-based applications and software-as-a-service play an important role in widespread health IT adoption? Or are there too many interoperability obstacles in the way?