April 22, 2014

This week athenahealth resigned from the Electronic Health Records Association (EHRA), the trade association that ostensibly represents the collective interests of the EHR industry in the many Washington, D.C.-based policy debates that impact EHR vendors and, by extension, their care provider clients. Members since late 2011, we joined the EHRA hoping to utilize the organization as a forum to spread our often-distinct points of view on particular issues — like the then-relatively-new Meaningful Use program — that were gaining prominence in the national debate over healthcare reform.

 We’ve all been in relationships where each partner tries, subtly and not so subtly, to change the other in fundamental ways. Those relationships go one of two ways: either one partner changes to suit the other or the relationship eventually breaks apart. There is an element of that dynamic in athenahealth’s breakup with the EHRA — but it isn’t the whole story.

At the end of the day, athenahealth left the EHRA because we never really belonged there in the first place. The EHRA was founded in 2004 by a group of EHR software vendors. Today, a decade into the age of cloud technology, the EHRA is still dominated and governed by a group of EHR software vendors.

That is not what we are. athenahealth is neither an EHR company, nor a software vendor. We operate as a services company that offers a cloud-based EHR as just one enabling component of our extensive suite of health IT services. Our public policy priorities are broader and more varied than those of the traditional software vendors that run the EHRA — and even where our priorities overlap, we’re too often on opposite sides of crucially important debates.

As a direct result of that frequent divergence, athenahealth is often obligated to explain to policymakers why we disagree with “our trade association.” This not only distracts from our point of view, it also undermines our credibility.

No single event led to our resignation, but some reasons for our parting of ways have come in the context of the Meaningful Use program. athenahealth steadfastly advocates for the aggressive timelines and high standards we believe are necessary to bring health information technology up to the standards of information technology used across the rest of the economy. One need only look at athenahealth’s latest Meaningful Use attestation statistics to understand just how significantly our clients’ results exceed the woeful norm. We are ready for 21st century standards, and we ensure that our clients are, too.

The EHRA, in contrast, consistently urges slower timelines, delayed deadlines, and lower bars. Why they do so is no mystery: many of their members’ static software systems are unable to meet Meaningful Use program timelines and standards. While we urge the Centers for Medicare & Medicaid Services (CMS) to publicly identify vendors whose provider clients seek “hardship” exemptions from looming program penalties, the EHRA presses just as hard to protect its members from the consequences of their failures by opposing any such disclosure.

In the days to come, we will work to identify other future-oriented health IT stakeholders to join with us in an effort to advance an innovation-friendly policy agenda in DC. And we’ll begin with the signatories to the five hard commitments set forth in our Health IT Code of Conduct (not one of whom is a member of the EHRA…).

With this effort, we’re not seeking to create a competitor to the EHRA so much as a higher-performing alternative — just as cloud-based health IT is increasingly viewed as a higher-performing alternative to anachronistic, static software platforms. One might say we’re performing a ‘rip and replace’ on our own outdated trade association.

If we can influence policy to better encourage innovation — to ultimately benefit care throughout the nation — perhaps a critical mass of caregivers will follow our lead…