Sunday, February 21, 2010

How to choose the wrong EHR for your office

Given all the discussions surrounding HITECH and ARRA, physicians are scrambling to choose electronic health records (EHRs) for their offices. Want to learn how to go through this process the wrong way? Then read this interesting story on Medical Economics titled, "How to choose the 'right' electronic medical record system." Ironically, the article starts with this: "Please, please, please do not do what we did. Do not purchase the wrong electronic medical record (EMR) system. This advice comes from someone who has championed the virtues of EMRs for decades. The difference is that I went from theory to reality.  And our clinic's reality stinks. It was not that we didn't try..." 

Wow, that's really a shame. I guess we all tend to learn from our mistakes, but the EHR selection and implementation process is not something you'll want to repeat. I've spoken with many physicians who regret having their current EHR. Now, it's much harder for them to justify spending another $30 or $60k to switch to a brand new EHR system. So, before you go out and choose an EHR vendor, make sure to do your research. Find a consultant if you need one. Get input from all your users. Consider clinical work-flow issues. Don't just go for the cheapest EHR system (although the cheapest system or even a free EHR could be the best "fit" for your practice). Make sure you have adequate support once your implement your EHR.

Click here to read the article on Medical Economics.


  1. I agree that price should not be the primary consideration for selecting an EHR. In my experience, people really regret how they use their EHR more than the vendor (although there are bad vendors). Implementing an EHR is so much more complicated and time consuming than most private practices are prepared to tackle.

  2. Just because an EMR is high priced doesn't mean it is good or bad or "just not good for your practice" but the reverse is also true, a lower cost EMR could be good if it's a fit for your practice.
    I believe what's more important is effective project management to help determine your requirements / assess your current status, establish goals, understand fears, assess risks / set mitigation plans and work with the time / resources you have.
    Good EMRs can go bad or even ugly (poor security measures!).

  3. Agree that sometimes a lower priced EHR is the best option for certain physicians or medical groups. In fact, I would even argue that some free EHR solutions are ideal for many solo physicians or small groups.

  4. The most difficult prospect for any EMR/EHR vendor is being able to sell their product with any core knowledge of how it works in practice. A good software company dedicates itself to development of its product, and cannot actually be practicing medicine at the same time. However, the dichotomy is that physicians need tools built by people who truly understand their practice.

    This area is difficult simply because EMR/EHR vendors simply can't "drink their own kool-aid". Security vendors can, as can companies selling Customer Relationship Management, but how do you transform a physician into a software developer? (If it went the other way, I am sure the software developer turned physician won't be the one writing code anymore.)

    It is important to realize this when approaching any EMR vendor, and to understand that their solution has been in clinical operation for a significant period of time. This will ensure that they have had time to inculcate the practices they support through trial and error. Another factor is to ensure that the implementations they have engaged in are actually of comparable size. Small practices versus group practices with hundreds or thousands of physicians have significantly different dynamics.