eClinicWorks – A Warning for EHR Developers

Law

The EHR industry has enjoyed its time in the spotlight for the last few years. Thanks to federal incentives and demand from providers, EHR adoption has soared. However, EHRs appear to be making headlines for the wrong reasons in 2017. The latest news in the healthcare industry is the settlement between the US government and eClinicWorks, one of the largest EHR vendors in the country.

Million Dollar Settlement

eClinicWorks has been facing charges under the False Claims Act and is now liable for paying about $155 million to the US to settle those allegations1. The settlement also includes a Corporate Integrity Agreement between the vendor and HHS-OIG that covers several aspects of the company’s software.

This case is the latest in a recent string of actions against EHR providers in the country. The DOJ has filed cases against other vendors for fraudulent claims regarding Medicare payments and similar actions. So what exactly went wrong in this particular instance?

False Claims Act

The case against eClinicWorks was filed under the whistleblower provisions of the False Claims Act. Under the terms of the meaningful use program, providers were offered incentives when they used certified EHR technology and complied with certain reporting standards pertaining to their use of health data. The government claimed that ECW obtained the required certification by hiding certain deficiencies in its software. So while the software did not actually possess the required features, it was certified. As a result, providers were paid the incentives due to them by the government.

For instance, the software did not have a comprehensive database of drug codes which can aid users while filling in data. Instead, the developers simply entered the required handful of codes directly into the software, ensuring it would pass the tests even though the relevant feature was absent. The software also did not record actions taken by users correctly, thus failing to provide an adequate audit log. The EHR failed to conduct certain checks in a few circumstances which could lead to wrong diagnosis or prescriptions.

Clearly, the software did not meet the needed standards set out by the government. Instead of helping providers improve the quality of care, it might have actually endangered patients through inaccurate data and incorrect data handling.

A Warning for EHR Developers

The case against ECW highlights certain issues, one being the problem of quality control in EHRs. In this instance, a provider was able to bypass the certification process set up to ensure that providers knew what they were buying. If you can’t trust the certification process, dentists will be hard put to evaluate different applications before purchasing one to fit their clinical requirements.

With this settlement, the government has also made its intentions clear. More cases against fraudulent vendors or overpayment charges down the line shouldn’t come as a surprise to anyone. If vendors don’t already have adequate quality control systems in place, they should start putting them in today.

What Can You Do?

Healthcare providers have little cause for worry as this case shows that the government is willing to go after the real perpetrators of such fraudulent actions. But it might be a good idea to sit down with your vendor and review the EHR systems and various controls in place. A periodic review of all the digital systems in the clinic is a good practice in general as well.

This situation is a warning bell for providers and the industry as well. Evaluate your choice of EHR thoroughly before signing on the dotted line. Purchasing certified EHRs from reputed vendors is only the first step to protecting against lawsuits in the future.

https://www.justice.gov/opa/pr/electronic-health-records-vendor-pay-155-million-settle-false-claims-act-allegations