One of my regular readers, sent me the following email about the availability of IT help for those implementing an electronic medical record (EMR).
If my conjecture about the mad rush for good quality IT help is correct, then I wonder if physicians will have to choose between experienced HIT contractors that have long waiting lists and may be overwhelmed with demand (particularly if they get greedy about taking on too many clients or have trouble scaling) or try to find a good but inexperienced firm that will be responsive.
Could be an interesting dilemma?
There’s no doubt that a physician’s IT support can sink an EMR implementation just as easily as a poor EMR vendor. I wonder how many failed EMR implementations should be credited to the IT people over the EMR vendors. I still give the lions share of responsibility for failed EMR implementations to the EMR vendors, but a large number are still thanks to poor IT support.
So, yes it is quite the dilemma. Either it’s going to slow the adoption rate of EMR or inexperienced IT people are going to cause lots of headaches for those implementing an EMR. I have a feeling we’ll have more of the later. The reasoning is simple. How do doctors know who is quality IT help and who is not? Answer: most don’t. I’ll have to think about ways in which I can help physicians solve this problem.
I personally believe that many good quality IT help companies will have trouble scaling as is described above. I know there are companies that have done this relatively well, but I personally think that scaling good help (basically people) is the hardest thing for any company to do.
Having worked for a home health care provider (perhaps not the same experience as a doctor’s office) and a lab management company over the past 7 years, I know first hand that when we looked into replacing our Practice Managment application with a big name player, there were a lot hitches. And most where not from the internal IT’s side. While the ‘big name’s’ sales team expounded the virtures of the their product, they failed to answer questions about their product. Saying instead, we would have to contact out programmers and get back to you. This happened when we also had in house meetings with 2 other ‘big name’ players. With the managers from our payroll, finance, billing, hr and IT departments at the table, we all left a bit bewildered.
Because the costs of the initial purchase and monthly maintenance were so high, our CEO was looking to cut costs where ever possible. And most of that would have come from the training budgets for in-house staff and IT; and the support contract with the ‘big name’ would also be cut down to bear minimum. Thus not giving us 24x7coverage.
I have also seen implementation teams from world known companies where they were constantly on the phone because they didn’t have the training to do even the most plain vanilla of installations.
As you can see from the above statements, the fault does not lie with any one group. The one commonality seems to be training or the lack of it. Companies need to understand that without sufficient training on all fronts, that the end result is almost guaranteed to have significant problems.
And in your last paragraph, talking about IT Help companies, if you are talking about the farming out of an applications Help Desk, then you are talking about talking to someone that is most likely reading from a screen and probably no real idea or experience working with the product.
Lastly, in the quote.. ‘…choose between experienced HIT contractors that have long waiting lists…’ You will always have to make this decision when any new regulation comes out and there are only a handful of experienced players. Just look at SOX and the auditors companies had to work with.
I personally would love to get on board with a EMR/EHR vendor and get some more experience, but they don’t seem to want to talk to anyone that doesn’t have a degree or is a nurse. Wake up people most good IT people don’t! They learned everything from the school of hard knocks.
Rich,
A lot of what you describe at the beginning is nicely avoided by smaller EHR companies. Anyone that’s grown a company knows that managing that growth is one of the biggest challenges. Many of these EHR companies have grown so quickly or acquired other poor EHR companies that they just can’t keep up with the support requests. I know of an instance for example of one of the EHR company’s largest installs not getting the response from the EHR vendor. If the largest install can’t get a response imagine if you’re a solo doctor’s practice with that EHR.
Certainly you have to be somewhat cautious with small EHR companies to ensure that they’re sound as well. However, they often are able to take a vested interest in your feedback and appreciate it. Finding an EHR company in the middle of those 2 extremes is the sweet spot.
John,
I’ve been reading lots of your posts and have really learned a lot about HIT’s role in EHR. I am currently an intern at a small IT managed services firm, and am kind of in way over my head. They specialize in assisting small medical practices with EHR implementation. I am a junior marketing major, with no background in healthcare or IT. I am currently writing a report which is our ‘core-story’ (a marketing tacit which is an educational narrative on why practices need to choose us over less expensive but less secure/reliable other IT companies). I was wondering if you wouldn’t mind having a few emails back and forth and pointing me in the direction on some statistics. I would be more than happy to share my final report with you, as well as all the research I’ve been compiling. I appreciate your time, and am sorry for leaving this as a comment, not an email, but I couldn’t find your address.
Happy Tuesday,
-Zach
Zach,
I always try to help when I can. I’ll shoot you an email so you can ask there.