> 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.
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.
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.
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?
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.
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.
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.
> How much should I worry about this as a developer?
It's hard to say without understanding the basis for the claims against the developers, which are separate from the case against the company and its officers. I can find both the complaints and settlement agreement for the action against the company [0], but not those against the developers.
I would say not much. Meaningful Use is/was a unique program. In this case it seems like there was a conspiracy to deliberately cheat the certification only implementing the 16 drug checks that the examiner was going to check.
The end result was CMS paying out large bonuses to health systems using the eCW software when they really shouldn't have.
> In this case it seems like there was a conspiracy to deliberately cheat the certification only implementing the 16 drug checks that the examiner was going to check.
There's a lot more than the drug code hardcoding in this case.
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.
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.
Pretty interesting to see a Developer and PM have to pay out as well. I wonder how the judge reached that conclusion.