
EHR vendor eClinicalWorks to pay $155M to settle whistleblower suit - bm98
http://www.healthcareitnews.com/news/eclinicalworks-pay-155-million-settle-suit-alleging-it-faked-meaningful-use-certification
======
rubiquity
> _Navani, along with CMO Rajesh Dharampuriya and COO Mahesh Navani are liable
> for the payment of $154,920,000, while developer Jagan Vaithilingam is on
> the hook for $50,000 and two project managers, Bryan Sequeira and Robert
> Lynes, each owe $15,000, the Vermont DOJ said._

Pretty interesting to see a Developer and PM have to pay out as well. I wonder
how the judge reached that conclusion.

~~~
markolschesky
The developer loaded the hard-coded data to evade detection and the PM oversaw
the process where the data was validated against the government's test harness
for Meaningful Use. I suppose you could argue that those people would have
pushed back on the lack of ethics in the situation and halted the process to
prevent their certification.

~~~
rubiquity
Thank you for that bit of info. I would say that is quite unethical and worthy
of a fine. I wonder why the developer gets it worse than the PMs though given
how pressure tends to land on developers rather than the other way around.

------
pmiller2
It looks like they fined officers of the company, as well as a developer and 2
PMs. Is this standard practice for False Claims Act suits? How much should I
worry about this as a developer?

~~~
FLUX-YOU
IANAL and I can't find the court documents, but probably not much. Not unless
you are offering up solutions to intentionally bypass the requirements.

Having worked at an EHR, PMs routinely instructed us to build things
specifically. I could suggest cosmetic stuff, but couldn't really suggest
changes to the underlying business logic of the requirements because it had
usually been hammered out by PMs/Nurses/Doctors/Maybe-legal. These
requirements formed the basis of test cases for QA to run though.

ECW was not the vendor I worked for, so it's possible the developer had more
influence over business logic or its implementation.

These things sound like time or cost-cutting measures:

>opted to added the 16 drug codes necessary for certification into its
software rather than enable the product to access those from a complete
database

Sounds like they didn't buy the database.

>eClinicalWorks did not satisfy data portability requirements designed to
enable doctors to transfer patient data to over vendor’s EHRs

This sounds like they didn't want to build something to export to CCDA?

These sound like negligence / not enough testing:

>failed to accurately record user actions with audit log functionality

>did not always accurately record diagnostic imaging orders or conduct drug-
drug interaction checks

For drug-drug interaction, that is probably another drug database to purchase,
so it's possible they simply hadn't bought it. Building your own is obviously
out of the question.

~~~
ch4s3
Yeah DDI check are tricky, and you basically have to buy a solution.

As for the CCDA piece, that's interesting. It should be pretty easy to build
that, it's a pretty simple standard and I think there are C# and Java libs
that basically just do it.

~~~
ndonnellan
> It should be pretty easy to build that

lol. It's not the standard that's hard, it's how every EHR vendor has
implemented it.

*ehr employee who's worked with CCDA and FHIR

~~~
ch4s3
Yeah, the implementation vary quite a bit. FHIR seems like it might actually
be nice.

~~~
schreiaj
Dig into it a bit. It's not. :/

Maybe 80% of it is nice and sane and then you realize that it also seems to
work for animals and you have a wtf moment.

I haven't dug into it in detail since DSTU2 though.

~~~
ch4s3
Yeah, the veterinary part is pretty stupid. Do you know the history behind
that? Is it related to using the standard for research?

The DSTU2 json representation isn't bad(for the healthcare), and it's easier
to work with than a lot of the adhoc in house apis I've seen. Though, Athen's
api is nice. I do wish that FHIR did something like the CCDA, it's convenient
to be able to consume health history in 1 shot.

------
beachwood23
Interestingly, this lawsuit was filed in my home state of Vermont -- because
Vermont is "sympathetic" to fraud charges.

~~~
r00fus
Wow I wonder if jurisdiction shopping might have a positive outcome here (a
opposed to e.g. East Texas for patent markman findings).

------
DominoTree
For several years, I worked doing installs for eCW and I have nothing but
negative experiences to report about the software and the company itself. This
is wholly unsurprising.

~~~
bnjms
Do you have any experience with any other EHR software and if so what do you
like? Years ago I did installs of Amazing Charts for small offices. And where
I initially was optimistic about their growth prospects I was eventually
disappointed in their growth after government requirements took effect. At the
time eCW and E-MDs were the cool products on the main physician message board
and at least one of my former clients eventually migrated. I had thought they
were in better hands though perhaps not.

------
nobodyorother
20% payout to the whistleblower. That's pretty hefty!

