In my previous post about the EHR certification costs, a reader emailed me that I’d missed an important downstream cost. It’s not as much a cost for the EHR company as it is for the current user of an EHR system. It’s the cost for a current EHR user to upgrade their software to the latest and greatest version of the EHR software. You know, the one that is certified and allows you to show meaningful use of that EHR.
All EHR Will Need to Update
Lest you don’t think this is going to happen, I can pretty much guarantee that EVERY EHR company will need to upgrade their software to become a certified EHR and meet all the meaningful use requirements. The good thing is that most EHR users have a contract that provides them with all the upgrades free. Although, there might be some users that will incur a cost to upgrade.
Less Visible Update Costs
Beyond the potential cost to get the upgraded software, there’s also the cost to physically update your EHR software. There’s the very apparent cost of having to run a software install on all the computers in your clinic. This is pretty negligible for a small clinic with only a couple computers. However, in one clinic I supported we had 100+ computers and so the update process did take time.
However, more important than the actual software update is the process of preparing for the update. Certainly you could just update the software and go forward with it. Although, this is far from recommended and can be really problematic. I should cover this topic in a future blog post, but suffice it to say that the upgrade process goes much better when you 1. Look over the new features/changes to the EHR softare 2. Test the changes to see how they work 3. Train your staff on the new changes and how it will affect their workflow. These are all pretty academic steps, but they do take time.
SaaS EHR Vendors
Of course, the SaaS-hosted EHR vendors will all really enjoy this part of the process. They can easily update their EHR software to meet the guidelines with little interaction or work from the customer end. They still could cause the headache of an update to their EHR software affecting a clinic’s workflow. However, most SaaS EHR software companies are doing many regularly scheduled smaller updates as opposed to the large traditional client server EHR updates. These smaller changes generally cause fewer issues or at least spreads those issues out over time.
Even More Hidden Update Costs
I recently was aghast to learn of the EHR update requirements for a certain very popular EHR vendor. They’d told a clinic (or at least given them the impression) that in order to update their clinic to the latest EHR software that met the meaningful use and certified EHR guidelines (which is kind of silly since there still aren’t any officially recognized Certified EHR, but I digress) that the clinic would need to have computers that ran the Windows 7 Operating System. The sad news for this clinic was their current Windows XP machines weren’t powerful enough to run the Windows 7 operating system.
Let me translate what this means for the less tech savvy readership. The clinic would need to buy all new computers and the Windows 7 operating system (which should come on the new computers) in order to upgrade their EHR software to the latest meaningful use-certified EHR software. One could certainly argue that the clinic might need to upgrade these older computers anyway, but something doesn’t feel right about this being “forced” on a clinic. I personally still use Windows XP and don’t see much benefit to pay for a new computer with Windows 7. I will at some point, but there’s no compelling reason for me to move now. Why should clinics be forced into this expense by an EHR vendor?
Certainly Windows 7 and Windows XP are not ALL that different, but be sure that the change will cause some heartache in a clinic. Some mundane task that a user use to do easily in Windows XP will require a change to make it work in Windows 7. It’s easy to quantify the cost of new computers with Windows 7. It’s much harder to quantify the cost of this heartache.
Ongoing Update Costs
Many of these costs aren’t generally meaningful use specific. These costs or some variation are going to be part of the EMR update costs going forward. Unless your EMR vendor stops updating. Although, if your EMR vendor stops putting out updates, then you have a much different problem to deal with.