As chair of the CHIME Advocacy Leadership Team, David Muntz is as plugged into the Meaningful Use saga as any non-government employee can be. And to hear him tell it, the interim final definition of MU needs to be significantly tempered if the majority of healthcare organizations are to have the slightest shot at qualifying for HITECH funds. Recently, healthsystemCIO.com editor Anthony Guerra talked with Muntz about what’s wrong with Meaningful Use, and how the government can make it right.
… what happens when you cobble things together is it gets much more complicated because you have to essentially take on the responsibility of proving the functions work together as they should.
I am not spending more time with lawyers, but that’s partly because I’m choosing to work with fewer and fewer vendors.
So I hope we are able to get people to say, “Yes, the intended purpose of this is to help you with your clinical decision making, and I’ll stand behind my product’s ability to do that.”
GUERRA: You’ve voiced concern that large health systems like yours will not receive certification site inspections in time to qualify for the incentive money. Can you expand on that?
MUNTZ: The fact is that software environments change so frequently that even if you get a certified product, what happens when they release software updates? It may or may not protect the functionality that is required for certification. So even if you have one package, there’s a possibility the next package you put in may or may not do what it’s certified to do.
But the other issue I think that’s fundamental to this is just because you certified the package, does that mean I installed it to meet the requirements of the certification or the way it was intended to be used. And so many of the vendors have in their contracts that they won’t warranty that the software we just purchased should be used for clinical decision making, but that’s exactly why we purchased it. Then what happens when you cobble things together is it gets much more complicated because you have to essentially take on the responsibility of proving the functions work together as they should. What you’ve done is switched the certification responsibility from the vendors down to the users who are already overwhelmed with the implementation. I think that’s probably the most serious problem we have.
GUERRA: We’re talking about vendor contracting and making sure you’re protected as an organization, there are also many legal issues around privacy and security. It seems CIOs are spending more time with lawyers than ever before.
MUNTZ: The truth is I am not spending more time with lawyers, but that’s partly because I’m choosing to work with fewer and fewer vendors. One of the advantages of that is I can avoid contracts. When we drafted our master contracts, we tried to do it in such a way that we could avoid additional contracting. So we have pursued an approach of contract avoidance.
In terms of do I think CIOs will be busier with lawyers, absolutely, because I think until we get the security provisions tested, we’re going to be more vulnerable. I hope we get some legislative relief from those kinds of things, but I’m not hopeful about that.
Senator Grassley is trying to make sure vendors are incapable of showing something and then declaring it’s not usable for that purpose. So I hope we are able to get people to say, “Yes, the intended purpose of this is to help you with your clinical decision making, and I’ll stand behind my product’s ability to do that.” When we get to that point, I don’t think we will need as many lawyers.
GUERRA: It sounds like you’re pursuing a best-of-suite approach to working with vendors.
MUNTZ: Absolutely. You know the truth is you want to buy the system as a whole. Let’s assume there are several third-party applications contained within the one that’s offered by our primary HIS vendor, then to the degree they provide that many more third-party products, I should be protected. The problem has been most people pass on the legal documents and the requirements, and so contracting with a primary HIS has gotten a lot more complicated than it used to be. Once it’s done, however, it’s easier to move forward.