I recently had a chance to talk with Sean West, VP & GM of HealthPort Data Conversion Services, about the hot topic of EMR switching (or EHR switching if you prefer). I’ve written about EMR switching many times before and even predicted it would be a hot topic a year or two ago. I assure you that it is going to become and even more important topic going forward.
During my discussion with Sean, I took note of a number of drivers behind all the EMR switching. Here’s what I consider to be the top three drivers:
Hospital Acquisition – I’ve written regularly about the trend of hospitals acquiring ambulatory practices and hospitals acquiring or merging with other hospitals. In one hospital system, I found that they were moving newly acquired practices onto the hospital EHR before they even moved their existing practices from paper to the hospital EHR. In many cases the acquired practices already had an EHR and so they had to make an EHR data conversion plan. Most current hospital acquisitions or mergers are also moving to one unified EHR software system. I could see this changing as larger more established hospitals are acquired, but right now these hospital acquisitions are driving a lot of EMR switching.
EMR User Dissatisfaction – There’s a broad range of EMR user dissatisfaction that prompts an EMR switch. Sometimes the healthcare organization is on a legacy EMR system that’s no longer being updated and so the user experience suffers. Other times we are talking about a newly implemented EMR system which doesn’t live up to the users expectations.
Not Meaningful Use Ready – The other large driver of EMR switching is when an EMR vendor isn’t or won’t be ready for meaningful use. The EHR incentive money and EHR penalties are a powerful incentive for many healthcare organizations. If an organization’s current EHR system isn’t ready for meaningful use, many have no choice but to switch EMR.
Of course, EMR switching can be a real challenge and every EMR switch is unique. You have to consider what you want to do with your old data. Do you have a way to transfer it to the new EMR? Can you get the EMR data out of the old system? Do you want to transfer all or part of the data? Do you not want to transfer the data to the new EMR, but you still want to keep the old EMR around to access the previous EMR data?
Many of the answers to these questions are heavily influenced by your original EMR contract. Sadly, many organizations did a poor job evaluating their EMR contract before they signed it. This can often lead to the old EHR vendor holding the EHR data hostage. It’s not pretty, but there are sometimes workarounds. Just be sure that you don’t make the same mistake with your new EHR vendor. My e-Book on EHR selection has a whole section on EHR contracts (starts on page 30) that you should consider.
EMR switching is never a fun experience, but it’s often a necessary evil. Plus, it’s going to continue to become more and more common. In fact, the next wave of EMR switching might be driven by EMR consolidation.
This is one of the most relevant topics today. I see an ever increasing number of ‘switchers’. Besides the ones that join a hospital or merge with larger groups, the rest of them are from the following camps.
1. Those that were skeptical about EMR initially, did not want to spend money and went with the Free EMR systems. They got their first year’s Incentive money, and realized they need to ‘grow up’, because the free emr just did not cut it and meet their needs. So, they start looking for something better.
2. Switchers from ‘older technologies’. Under this umbrella, you have those that are a) moving from old client server technology to Cloud EMR, because their IT costs are going up, their servers are aging, and so is the EMR system itself. Even if the software is certified, they want a Cloud system for various reasons – access, not having to deal with vpn, remote access, speed, etc.
3. Switchers because of ‘service and support’ issues. I see this also forming a large group. The reason is, market pressures are showing on Vendors. Costs rising, competition rising, it is becoming difficult to continue providing the same level of support as they did when they had fewer clients.
4. And, finally, Provides are Maturing. They are more knowledgeable. When they bought their first system, very few providers knew what they really wanted and what to expect. Having used technology for some time, they have a better understanding of their needs. So, if their current system can’t do it, they start looking for something that matches their needs.
Once you’ve decided to switch, then comes another hurdle which John and Sean talk about here – very important and relevant topics of contract, data conversion costs.
[…] Lynn talked about EMR switching and notes three drivers of this phenomenon. But there are […]
Thanks John. Makes one think twice before switching. And gives practices a great list of critical questions to ask incoming vendor.
Thanks John, It’s certainly ideal to address data access in the contracting stage. However, HealthPort DCS helps providers navigate conversion needs they may face today. Facilities facing a conversion challenge can start the conversation here: https://healthport.com/campaigns/Request_a_Consultation_DCS.aspx
Very interesting article. As a registered coder & biller and as a IT trainer on PM/EHR we see the very things discussed in this article up close and personal with the switching of EHRs… Bottom line is if the EHR and PM doesn’t work well together then the money flow slows down and you can not operate without the money. That’s what the Physician’s are seeing happening with their PM/EHR systems and they have to make a change to get the cash flowing again.
Then there is the Stage One steps towards the Stimulus Money….not to mention who is ready for Stage Two? Painful and upsetting to the whole office when you have to do work-arounds to get your EHR system to provide the Core & Measure Sets required and that’s if you CAN get them to work. OK- now we are at the “Support” from your EHR vendor issues…. Again, you better have a good support team. Word of mouth referrals? Yeah, if Dr Smith has all of the above working and is getting paid then Dr Jones is going to move over to that EHR since he needs to get paid too. We have not even talked about what’s around the corner…can you say EHR with ICD-10 fields up and running for 2014? It’s going to get even more interesting in 2014 with the EHRs……
JA Reynolds,
Thanks for sharing your experience and comments. They’re very much appreciated.
As for the PM/EHR integration, you must not also forget the impact of a crappy PM that comes bundled with the EHR you like. This can be just as much of an issue as a bad PM/EHR integration.
The word of mouth comment about how well an EHR does MU is really interesting. I wonder how many are doing that.