EMR Ethical Dilemma

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I was really intrigued by this well done article by Dr. Richard Hom about the Ethical Dilemma of the EMR. In it he describes the difference between the EMR technology world that will “sell anything at any cost” against the medical community values of things like the Hippocratic Oath.

He ends the post with these stinging paragraphs:

But medical angst persists. Because the EMR vendor is pursuing a “top down” sell, they bypass the medical leadership and pitch the C-level administrative staff. The medical input is usually an afterthought and the medical angst continues.

Countering the medical angst and overcoming the perception of “business ethics” being ugly will not be easy. If there be a truth in medicine, it is the gaining and loss of trust. Trust is not a trivial matter that can be bandied about just for a sale. To belie the image of the untrustworthy EMR vendor, both vendors and medical professional must make this their primary goal and objective even before the first sales pitch is given. The reward is either an EMR project that is successful after two years or an unsuccessful project that lasted ten years. The shipwrecks of EMR failed projects are a testament to that result should we forget this difference in world perceptions.

I agree that trust is really the key to a successful long term relationship with a doctor’s office. The sad part is that far too many EMR vendors aren’t interested in the long term relationship. They’re making the quick sale and then looking for the next sale. I really believe that a number of EMR companies are going to quickly scale to a level of sales where they can’t support the growth and then sale off to another competitor.

However, more important might be those EMR vendors who go in for the quick sale and then leave the clinics hanging during the EMR implementation process. You all know stories of what I’m talking about. I suggest that it’s only going to get worse not better.

Add in the EMR stimulus money and the natural increase in initial (at least) EMR adoption that will occur and even many well intentioned EMR companies are going to be caught in the trap of trying to support all these EMR installs. Lack of support from the EMR vendor is going to lead to even more EMR failures.

Naturally, all of these increased EMR implementation failures will taint the EMR industry even more and slow EMR adoption worse than ever.

Not to be all doom and gloom. I’m just highlighting one possibility. What’s the solution?

1. EMR vendors don’t over sale (this will be nearly impossible and takes a special vendor to not do this).
2. Doctors, do more research about the EMR vendor you select. I call it an EMR vendor background check.

EMR is the future, but the question is how long until that future is the present.