Second EHR | EMR and HIPAA

Rip & Replace EHR, 3rd Party EHR Connections, and EHR Advice from a Physician

@hospitalehr: For community hospitals, “rip & replace can’t be good for morale, finances or patient care” bit.ly/T7rS2B #healthIT

— PatientKeeper (@PatientKeeper) December 19, 2012

It’s not good for morale, finances, or patient care. Although, it might be better than being stuck with an EHR that is worse for morale, finances and patient care. It’s not an easy decision to switch EHR, but sometimes it’s necessary. Although, this is an almost impossible decision for a hospital. See this post about the “Wrong EHR” conundrum.

@toughloveforx With millions spent- We’re stuck w/clunky EMR’s. Need to let 3rd parties plug into systems w/hcp leadership #CPHC #ecosys

— Gail Zahtz (@GailZahtz) December 18, 2012

I’m not sure how much of this twitter thread will embed. If it doesn’t, then here’s a link to see the full thread. I hope that we can continue to raise the call for more open systems and access to EHR by third party software! Which EHR will set themselves apart in this regard?

@drnoahnd 1 Keep your focus on the pt 2. Pt & doc should view EMR together 3. support transparency – pt sees everything 4. Do EMR real time

— Richard Vaughn MD (@rvaughnmd) December 17, 2012

Great advice for every doctor when it comes to EMR. It’s a hard shift for many, but I expect Dr. Noah won’t have any issues with this advice.

Most Expensive Purchase is Second EHR

Written by: John Lynn

At an event this fall I happened upon an executive at one of the major EHR vendors. We had a brief discussion in the lobby, but he said something that I found really interesting and I think describes the strategy of many of the large ambulatory EHR vendors. Here’s what he said:

“The Most Expensive Purchase is Their Second EHR”

A popular EHR consultant was in on the conversation and he started shaking his head in agreement.

I’ve long suggested that practices usually get their second EHR selection and implementation right. It just makes common sense that a practice would use the lessons learned from their first EHR implementation and be able to do a better job selecting and implementing the second EHR implementation. Although, I have heard of cases where it took the third implementation to do it right.

What intrigued me more was that this EHR vendor executive tied the purchase price to a second EHR. He’s right that price becomes a very different discussion when you are talking to someone who is buying their second EHR. In a lot of cases, price becomes a non-issue for those implementing their second EHR. They will spend whatever amount is needed to be able to get an EHR that they like to use. This is reflected in the quote above. I expect that’s why a second EHR is the most expensive purchase.

I wonder how many EHR companies are capitalizing on this fact. I’ve heard from numerous people that there’s a lot of EHR switching that’s happening right now. So, the idea of a second EHR is not outlandish. For many, the second EHR implementation has become a major reality.

EMR Switching Encouraged by Meaningful Use

Written by: John Lynn

For the past year or so I’ve been predicting that one of the top EMR and EHR related topics will be EMR switching. Yes, that’s right. A practice or doctor switching from one EMR to another EMR. At HIMSS it was suggested to me that meaningful use was a big driver in doctors switching EMR software.

I find the idea of meaningful use driving doctors to change EHR software quite interesting. It makes some sense when you consider that some of the EHR software that doctors currently use isn’t a certified EHR and/or will make it difficult for them to show meaningful use. More common is the HUGE number of physicians that have to upgrade their EHR software. This is a bit of a travesty to me. In any release of EHR software there’s always a mix of new features, security fixes and other optimization. Why a doctor wouldn’t want all of these things is hard for me to understand.

I guess part of the problem with staying updated to the latest EHR software has to do with the client server model that many EHR software companies use. Upgraded client server software isn’t always easy or fun. There’s some things you can do to streamline it, but it takes time. When the upgrade doesn’t offer a new feature that a doctor wants to get his hands on, it’s hard to justify the costs associated with the upgrade. I’m talking about time costs to upgrade, not software costs to upgrade. Unfortunately, most doctors don’t think too much about the security implications of not updating their EHR software.

Meaningful use has definitely gotten a lot of doctors to upgrade or replace their EHR software. This seems like something that should have happened naturally, but I believe it’s a good outcome of meaningful use.

Going back to switching EMR software, I’ve heard from a number of EMR vendors that some of their best EMR sales are to those that already have an EMR. I know I’ve done a much better job buying my second cell phone than I did my first. I knew what I really wanted when I bought my second one. The same seems to apply to doctors buying their second EMR.

Don’t get me wrong. I’m not advocating that doctors switch EHR in order to get a better one necessarily. It would be a really terrible thing if the way to get a quality EHR was to implement one first and then switch EHR. However, as time goes on there are going to be a HUGE variety of reasons to switch EHR software. Meaningful use might be driving EMR switching today, but there are going to be other factors driving doctors to change EMR in the future. Not the least of which could be a large number of doctors who focused too much on meaningful use and EHR incentive money and not nearly enough on the way the EHR selected will impact their practice. The other likely cause will be EHR consolidation and EHR software companies going out of business.

The real problem with all this EHR switching will be the lack of standards and flexibility around pulling the data out of the old EHR. I still have in mind some ways to hopefully help with this problem, but it’s a monumental task.

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March 6, 2012 I Written By John Lynn