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August 11, 2009

Problem with EMR Selection Process

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I read a number of online forums and blogs about EMR. Most of the time I’m amazed at all the smart people that are participating in the discussion of EMR. However, occasionally I come across comments that just make me cringe. Here’s one of those comments about the EMR selection process:

Key factors to consider are cost of licensing; maintenance and any other cost of ownership fees; types of service level agreements (SLAs); redundancy/mirror imaging (ability to minimize downtime or restore system in minimal time or an alternative process for business continuity); types of technical environment/architecture required; security and access points; implementation costs (avoid customization or keep them to a minimum whenever possible); maintenance costs for customizations, which vendors sometimes treat as a separate cost; cycle for upgrades/fixpacks/major version releases and support; training development and delivery; and optimization to ensure the system is being used as effectively, productively, and efficiently as possible throughout its life cycle. Hopefully, there will be some standardization of key features to ensure ease of usability in the near future.

Are those the key factors that should be considered in selecting an EMR in your book? Not that a number of the items aren’t important. However, most of that list doctors I know don’t care about and quite frankly they shouldn’t. I think most doctors look at the selection in this way: cost/ROI, usability, and let some tech person deal with all the technical details. I think that many have a challenge measuring these, but at the end of the day the ROI and usability of the software is all they really care about. Is that such a bad thing?

What’s interesting about the above statement is that the following statement preceded it:

I would recommend that physicians invest in a reputable and health care industry focused consultant or consulting firm to help in the vendor selection process to determine which system best fits their needs.

I can’t argue with this advice. However, the list of EMR selection “key factors” above makes me think that whoever made the list isn’t a “reputable” EMR selection consultant.

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    6 responses to "Problem with EMR Selection Process"

    1. # Brad commented on August 11th, 2009:

      EMR Consultants scare me to death. I would almost venture to say that MOST consultants are way more worried about leading you into an EMR that will get them the most commission rather than the RIGHT EMR for the site.

    2. # John commented on August 11th, 2009:

      I agree Brad. Might I reference my article on EMR Consultants: http://www.emrandhipaa.com/emr-and-hipaa/2009/02/24/my-article-on-understanding-the-types-of-ehr-consultants/

      We cover a lot of that. I call them EMR Salespeople dressed in EMR consultants clothing. That will definitely be a major section of the e-Book.

    3. # Peter J Polack MD FACS commented on August 12th, 2009:

      I agree. Many Practice Management Consultants are now…EMR Consultants.

      I think cost is definitely an issue but ROI is difficult for medical practices to get a handle on. And many doctors feel it is becoming a moot point – with legislative mandates looming, many are just trying to get something ‘reasonably-priced’ and let it fly.

      Not necessarily the best strategy but there is a dearth of reliable advice and information out there.

    4. # John commented on August 12th, 2009:

      Peter,
      I agree that many have a real challenge trying to find reliable information about EMR companies. That’s why I’m trying to do my part.

      Thanks for commenting and I hope you’ll join in with more of the conversation. Always nice to have another MD commenting on the site.

    5. # Justin Campbell commented on November 11th, 2009:

      John,

      I don’t know if you’ve already covered the results from the AC Group’s “Digital Medical Office of the Future Survery,” and please forgive me if you have, but I think it provides a pretty good free assessment of the EHR vendor landscape complete with review (albeit a bit dated): http://www.mag.org/pdfs/ehr_study_acgroup_120408.pdf

    6. # Jawad Habib commented on November 17th, 2009:

      I am generally shocked to see such vendor-sponsored comments. Goes to show how “unethical” marketers are even in a vertical which has such a strong ethical foundation!

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