Technology companies have always struggled with the “build versus buy” conundrum, but the decision is particularly vexing for healthcare IT. It’s not that companies can’t produce great software. They can. It’s not that “ownership of the IP” isn’t important. It is. The real issue HIT firms face is the constant balancing act between meeting regulatory demands and focusing on innovation. Increasingly, the time and capital spent to build and repeatedly rebuild relatively commoditized features is draining the opportunity to spend that same investment on new and competitive capabilities.
In the world of healthcare IT, regulatory changes at the federal or state level, provider incentive programs driven by government or private payers, and continually updated standards drive technology vendors — and EHR vendors in particular — to devote substantial resources to keeping key elements of their software up to date. The effort and expense have many of them thinking hard about opportunity costs, slowed pace of innovation, and potential options for staying viable in a market that has become increasingly saturated.
NCPDP SCRIPT2017071 is the most recent example of a new industry requirement that EHRs must meet to deliver a viable and certified system to their prescribers. SCRIPT17 is a new standard that’s designed to improve patient safety, clinical decision-making, and administrative efficiencies, and has a quickly approaching deadline of January 1, 2020. While SCRIPT17 is expected to close some of the quality and efficiency gaps that still remain in the electronic prescribing process, its implementation will require yet another heavy lift from EHR development teams. And time is running out.
Although the revised NCPDP standard is possibly the largest and most costly mandated change healthcare technology companies have faced around the prescribing process recently, there has been a long history of mandates. For instance, the industry is still working through development on rules for managing the opioid epidemic through electronic prescribing of controlled substances and related technologies, which have been ongoing and vary by state. Previous regulatory and industry requirements that have impacted EHRs include NCPDP standard revisions (8.1 and 10.6), 270/271 eligibility requirements, Meaningful Use, as well as demands that EHRs improve the scalability and security options available to their customers.
