Medication Management Traps for EHR Vendors

Almost 20 years ago I wrote an article titled “Develop Your Own EMR – Are You Crazy,” followed 7 years later by the article “Develop Your Own EMR – You’re Still Crazy.”  The premise of those articles was that no one feature of the EMR was a barrier to entry for those wanting to create a new EMR.  However, the sheer number of features and functions that were required to make the EMR usable were a tremendous barrier to creating a new EMR.

Fast forward 20 years and I could have entitled this article “Develop Your Own Medication Management – Are You Crazy?”  Certainly the EMR has gotten more complex, but it’s safe to say that medication management within the EMR has gotten so complex that it’s really hard for an EMR (or should we say EHR now?) vendor to keep their medication management efforts up to date.  It’s not that any one component is a challenge, but it’s the massive number of features, regulations, and reimbursement requirements that makes building and maintaining your own medication management system so difficult.  Plus, medication management has expanded beyond ePrescribing to encompass patient benefits, prior authorization and adherence—each with multiple stakeholders.

This idea became really apparent to me when we started co-creating the eBook “7 Medication Management Traps Waiting to Ensnare EHR Vendors (And How to Avoid Them)” together with the medication management experts at DrFirst.  When you read through the 7 traps highlighted in this eBook you can see why so many EHR vendors have chosen to partner with a medication management expert rather than going it alone.

Let’s look quickly at just two of the traps highlighted: Regulatory Compliance Burden and the ‘Take 1 Tablet Daily’ Problem.

While one may think that regulations around medication management and ePrescribing change rarely, the reality is that’s just not the case.  We’re not talking about something like kindergarten math which is still the same as it was 20 years ago.  The reality is that the regulations are changing all the time.  In fact, the various medication management regulations are part of a multi-year roadmap that has fundamentally rewritten what’s required.  Plus, there’s no sign that this is going to slow.  In fact, I’d describe the regulatory environment as multiple layers of regulations that have to all be considered and complied with in your medication management system.

Even though these regulations are important from a business and compliance perspective, it is safe to say that most EHR vendors that do this on their own are spending time on compliance as opposed to innovation.  Every EHR vendor I know has a long list of innovations they would like to implement for their end users.  There is no lack of opportunities for EHR product teams right now to innovate.  However, how many of them are stuck dealing with compliance rather than innovation?

Moving on to the next trap: the ‘Take 1 Tablet Daly’ problem.  One might assume that after over a decade of work on standards that all of your prescription data would be standard and could flow freely between systems.  While we have certainly made progress on prescription standards and data sharing, there is still a long way to go and a lot of nuance within those efforts.

In the eBook, we share that there are 832 known permutations of the instruction “take 1 tablet daily.”  I’ll pause while you pick up your jaw off the floor.  It is hard to imagine all these different versions of the same phrase, but this is the reality medication management systems face.  Plus, let’s extrapolate this across sigs, race and ethnicity data, diagnosis codes, allergy information, drug identifiers, and much more.

Managing all of these different variations has a real cost.  A cost to the EHR vendor that is trying to maintain this at scale across a wide spectrum of users.  However, there is also a cost to the doctor, pharmacist, and patients that have to deal with the data quality issues when they are not managed properly.

Those are just two examples of the complexity of medication management today.  Be sure to download the Free eBook “7 Medication Management Traps Waiting to Ensnare EHR Vendors (And How to Avoid Them)” to learn about the other 5 traps and some ways to avoid them.

The reality I have seen when talking with EHR vendors is that having the right partners in their tech stack is key to their innovation efforts.  Choosing the right partners frees them up from doing the mundane work of meeting regulation requirements.  This lets them focus their development efforts less on regulation and more on innovation.  Plus, the right partners will help them with their compliance requirements while providing innovative offerings within that specialty focus.

Almost 20 years ago I wrote an article titled “Develop Your Own EMR – Are You Crazy,” followed 7 years later by the article “Develop Your Own EMR – You’re Still Crazy.”  The premise of those articles was that no one feature of the EMR was a barrier to entry for those wanting to create a new EMR.  However, the sheer number of features and functions that were required to make the EMR usable were a tremendous barrier to creating a new EMR.

Fast forward 20 years and I could have entitled this article “Develop Your Own Medication Management – Are You Crazy?”  Certainly the EMR has gotten more complex, but it’s safe to say that medication management within the EMR has gotten so complex that it’s really hard for an EMR (or should we say EHR now?) vendor to keep their medication management efforts up to date.  It’s not that any one component is a challenge, but it’s the massive number of features, regulations, and reimbursement requirements that makes building and maintaining your own medication management system so difficult.  Plus, medication management has expanded beyond ePrescribing to encompass patient benefits, prior authorization and adherence—each with multiple stakeholders.

This idea became really apparent to me when we started co-creating the eBook “7 Medication Management Traps Waiting to Ensnare EHR Vendors (And How to Avoid Them)” together with the medication management experts at DrFirst.  When you read through the 7 traps highlighted in this eBook you can see why so many EHR vendors have chosen to partner with a medication management expert rather than going it alone.

Let’s look quickly at just two of the traps highlighted: Regulatory Compliance Burden and the ‘Take 1 Tablet Daily’ Problem.

While one may think that regulations around medication management and ePrescribing change rarely, the reality is that’s just not the case.  We’re not talking about something like kindergarten math which is still the same as it was 20 years ago.  The reality is that the regulations are changing all the time.  In fact, the various medication management regulations are part of a multi-year roadmap that has fundamentally rewritten what’s required.  Plus, there’s no sign that this is going to slow.  In fact, I’d describe the regulatory environment as multiple layers of regulations that have to all be considered and complied with in your medication management system.

Even though these regulations are important from a business and compliance perspective, it is safe to say that most EHR vendors that do this on their own are spending time on compliance as opposed to innovation.  Every EHR vendor I know has a long list of innovations they would like to implement for their end users.  There is no lack of opportunities for EHR product teams right now to innovate.  However, how many of them are stuck dealing with compliance rather than innovation?

Moving on to the next trap: the ‘Take 1 Tablet Daly’ problem.  One might assume that after over a decade of work on standards that all of your prescription data would be standard and could flow freely between systems.  While we have certainly made progress on prescription standards and data sharing, there is still a long way to go and a lot of nuance within those efforts.

In the eBook, we share that there are 832 known permutations of the instruction “take 1 tablet daily.”  I’ll pause while you pick up your jaw off the floor.  It is hard to imagine all these different versions of the same phrase, but this is the reality medication management systems face.  Plus, let’s extrapolate this across sigs, race and ethnicity data, diagnosis codes, allergy information, drug identifiers, and much more.

Managing all of these different variations has a real cost.  A cost to the EHR vendor that is trying to maintain this at scale across a wide spectrum of users.  However, there is also a cost to the doctor, pharmacist, and patients that have to deal with the data quality issues when they are not managed properly.

Those are just two examples of the complexity of medication management today.  Be sure to download the Free eBook “7 Medication Management Traps Waiting to Ensnare EHR Vendors (And How to Avoid Them)” to learn about the other 5 traps and some ways to avoid them.

The reality I have seen when talking with EHR vendors is that having the right partners in their tech stack is key to their innovation efforts.  Choosing the right partners frees them up from doing the mundane work of meeting regulation requirements.  This lets them focus their development efforts less on regulation and more on innovation.  Plus, the right partners will help them with their compliance requirements while providing innovative offerings within that specialty focus.