One of my favorite EMR people, Matt Chase from Medtuity, wrote this interesting comment over on EMR Update.

Times are achanging. I think a recent install is a good example. The group purchased a decently well-known EMR and it failed. So they went with a second well-known EMR and it failed. Both were certified. Both had a very active sales team. The second one flew in some upper level sales people from the coast when there was talk of deinstall.

After spending half of the national debt and a looming closure of the practice, they called in a consultant. He made his recommendation. They did their demo and they asked the really hard questions– show me how to create new clinical content, show me how to create a new template, edit an existing one, how to fax a single encounter to another practitioner, then multiple encounters but not all encounters of a patient, track any lab value over time, send a reminder to a staff member, assign faxes and scans, etc, etc. Their list was very long. They did not want to hear promises and they did not want a canned demo. They wanted to see the software perform the steps that were lacking (but promised present) in their previous software.

The underlying theme here is that practices believe that certification is truly a functional seal of approval. It is not. Secondly, because certification exists and so many EMRs (>450) are certified, it implies a mature product offering– like buying a hard drive or a computer. You can expect certain functionality to be present simply because the maturity of the market would have eliminated the company. Unfortunately, just the opposite is true.
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Just this week I learned that a very large practice in our town is out shopping another EMR. Yes, they have a certified one, but they certainly aren’t paperless.

Functionality will become the watchword of EMR, not certification.

That’s some interesting projections. I remember one EMR vendor telling me that a large portion of their sales were to existing EMR users. In fact, I think they said that there favorite implementations were existing users that were switching to their EMR. I also love the observation of how much better an organization is at selecting an EMR the second time they do it.

I saw an EMR demo today and they made a really interesting point about workflow. In fact, I was impressed that the EMR vendor admitted up front that you would need to change your clinic to work with their EMR software. I’ve said this a number of times on this site, but it was kind of refreshing to hear an EMR vendor admit it. I’ll have more on the rest of the demo/presentations in future posts.

What was most interesting was that after admitting that you would need to change the way you work to use an EMR, he made a really interesting and powerful point. The basic concept was that if you don’t have an EMR, your current workflow is bound by the paper world in which you now live. Hopefully, adding an EMR to the mix provides some new ways to serve patients that were impossible to accomplish in the paper world.

I think you could also add that implementing an EMR removes a bunch of paper queues. For example, we use to have a half sheet of paper that was filled out by the patient follow the patient throughout the entire visit. What were we going to do without that half sheet of paper? This is one of those workflow changes that isn’t a deal breaker, but just had to be considered and planned for.

Also, don’t confuse changes to your workflow with changes to how you treat a patient. Your workflow will absolutely change. We’ll save how an EMR affects how you treat a patient for another post.