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Avoiding EHR Performance Issues in the First Place

Posted on August 26, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In my post about the common EHR implementation problem of EHR slowness, I mentioned that I’d follow up with a post on how you can avoid the EMR slowness issue altogether. It’s better to avoid than fix problems.

The best way to approach EHR performance issues is to make them part of your EHR selection process. EHR performance issues could and should be a deal breaker for you when you’re evaluating EHR companies. How then can you identify EHR software that might have these performance issues?

Red Flag #1 – EHR Demo Slowness – Bring a red pen to your demo and every time they say something like, “It’s not usually this slow?” or “It must be slow because it’s running on my laptop.” make a BIG RED mark on your paper (or tablet if you’re advanced like that). Even one red mark should be cause for concern and investigation.

Certainly there are situations where environmental issues can cause slowness to an EHR. So, you can’t completely rule them out completely for this, but this is their demo. This is there one time to shine. If they can’t get their EHR demo running at full speed, what makes you think an EHR production environment will be much better?

You can make an extra red mark if it’s a SaaS EHR that’s providing the demo. They might say it’s just “the internet connection.” Well, guess what? Soon, that’s going to be you using that EHR and often on similar internet connections.

Of course, the message to EHR vendors is to make sure your demo runs as fast as your production system.

Red Flag #2 – Site Visit Slowness – While the demo can tell you a lot about an EHR software, it can’t necessarily tell you the speed of the EHR software. Just because the EHR is fast during the EHR demo, doesn’t mean that same EHR software will be fast in a production environment. Add this to the multitude of reasons why a site visit to a current user of that EHR is so important.

Make sure to do that site visit at one comparable in size and users to your clinic. You don’t want to look at the EHR responsiveness of a solo practice if you’re going to be a 6 provider multi clinic setup. Size matters when it comes to EHR speed.

Once on site, you can get an idea of the speed and responsiveness of the EHR software in two ways. First, observe the users of the EHR in the clinic. See if they exhibit any of the systems listed in the first section of this post. Another observation is to see how quickly they’re clicking around the EHR. If you see a lot of clicks in a row with little waiting in between clicks, that’s a great thing. If you see them click, wait, click, wait, click, click , wait. Be afraid.

The second way is to ask the EHR users. The problem with doing this is that only one response has value. If they say the EHR is slow, then you’ve gleaned some important information that’s worth checking on. If they say the EHR is fast, then you don’t necessarily know. The problem is that you don’t know what the user considers fast. What’s their frame of reference for saying it’s fast? Do they know what fast is? Have they just been using the EHR software so long that they’ve hit a rhythm that makes it feel faster than it really is? It’s a good sign if they say that it’s fast, but take it with a grain of salt.

Red Flag #3 – Use A Demo EHR System Yourself – Most EHR vendors will provide you a way to demo the product yourself. This isn’t a fool proof method to test EHR slowness, but it’s another decent test of the EHR’s responsiveness. Try it out using your internet connection and your computer hardware. Nothing like first hand experience documenting some patient visits to learn about the speed of an EHR.

EHR Speed Suggestion – Don’t Skimp on Hardware
Far too often I see a clinic skimp on the hardware requirements and regret it later. In fact, they often end up spending the money twice since they have to buy new hardware since they skimped in the beginning.

Of course, this suggestion can be taken too far as well. The computer and laptop manufacturers will try to sell you the whole kitchen and you might only need the stove and refrigerator. To put it in more practical terms, you’re going to want plenty of RAM, but do you really need the webcam, Blu-ray player, and special 100 in 1 media device?

Just because an EHR vendor says their EHR software can work on a certain hardware configuration doesn’t mean it should be used on that hardware configuration. In the middle there’s a spot between can and overkill that’s called optimal. Find that hardware configuration and you’ll be a much happier EHR user.

Conclusion
Don’t accept an EHR that’s slow. Make sure that the EHR performs at a satisfactory level. I know of nothing that frustrates a clinic more than a slow EHR.

EMR Vendor Software Test Drives

Posted on October 13, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As is often the case on blogs, some of the best commentary is happening in the comments. This has never been more true on this blog than this week. The comments have been thoughtful and there’s been some really interesting back and forth discussion.

One example of a discussion that began in the comments is around the benefit of being able to be given a demo EMR system that you can sit down and try. I’m not talking about a demo of the EMR software by someone (often a sales person) from the EMR vendor. I’m talking about a real life system where people on their own can go around and try out the EMR software.

There are so many things involved in this discussion that I’ll just throw out a few ideas and let the discussion continue in the comments. Do you load the demo EMR software with data or no? In some ways it’s better to have exactly what they’ll give you so you have an idea of how much you’re going to need to configure when you get the system. In other ways it’s better to have one loaded with the configurations, a few patients, lab results, etc so you can see what’s possible.

Certainly there are some challenge with certain platforms being able to easily provide a demo install. Large organizations can often do this, but small organizations might have a harder time getting a demo install. This is harder with client server EMR compared to web based EMR software. However, with virtual machines and other technologies, there are a lot of interesting possibilities.

I know one organization actually does what they call pilot installs where they install the entire system for you and will take it out if you don’t like it. You don’t pay until after the pilot period. I’ll add in more details about this vendor in the comments. Are there other creative ways to demo an EMR vendor before buying?

Ok, that should kind of get the juices flowing. Let’s hear your thoughts about EMR vendors providing a demo system for people to “test drive” before purchasing the EMR. I’d also love to know which EMR vendors provide this and links to their demo system would be great as well.

So, those of you who have been lurking on the sideline. Check out the comments and why not add one of your own.

My Least Favorite EMR Vendor Sales Line

Posted on May 26, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A feature of every EMR vendor is a whole multitude of sales lines. If you’ve ever talked to a EMR sales person, you know what I’m talking about. This isn’t really unique to EMR sales. The same can be said of most software that’s trying to solve complex problems.

Well, there’s one EMR vendor sales line that gets on my nerves more than any other line. Let’s take a demo of an EMR vendor’s templates. Now here’s the line that I absolutely abhor:

“You can make it do whatever you want.”

Hearing this is like hearing fingernails on a chalkboard for me. Certainly, the intent of their comment is that the EMR template creation is really flexible (and it very well might be). However, the superlative “whatever” is just wrong. Every software system has limitations and I can guarantee you that if you really start using an EMR system you’re going to bump into those limitations.

I guess my problem is using superlatives like whatever, any, all, always, etc. is just misleading and leads to what I call EMR sales miscommunication. Anytime you hear one of those things during an EMR demo (or even during an EMR training) you better start asking lots of questions.

Of course, these superlatives do a lot better job selling EMR software. I guess that’s why I’ll never be an EMR salesperson. Maybe it’s also why people seem to like reading my EMR blog posts.