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Large EHR Vendor Recommendation

Posted on February 1, 2012 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.

One of the more interesting dynamics in the EMR and EHR world has to do with large versus small EHR companies. I guess we’ve always loved a big versus small story ever since David slew the Giant Goliath. Plus, there’s something American that causes most of us to really root for the underdog. I don’t know what it is, but unless my team is playing I’m most often hoping that the underdog spoils the party and does something surprising. Maybe this is why so many of us love to pit the big EHR vendors against the small EHR vendors.

Personally I don’t have any particular preference for or against larger or small EHR vendors. I care more about choosing the right EHR vendor for the right situation. In some cases those are small EHR vendors and in some cases those are large EHR vendors. I only discriminate against EHR vendors who don’t perform. Many of those that don’t perform I call Jabba the Hutt EHRs. If you haven’t read my Jabba the Hutt EHR posts, you should.

Although, what prompted this post was a comment I read recently from a doctor who uses a large EHR vendor. I won’t say which EHR or who made this comment since it doesn’t matter to learn from the comment. They basically made this suggestion:I recommended a large EHR so that it can connect everything. Then he said that the large EHR vendor decreased productivity.

Certainly I realize this is only one person discussing why doctors should go with a large EHR vendor, but if I’m a large EHR vendor I’d be really upset if this is my message. And while this is one example, I’ve certainly heard it other times before.

Think about this message from a physician’s perspective. I can either go with an EHR product that decreases my productivity (Translation: I make less money) or with an EHR product that can connect everything (Translation: That’s nice, but does it save me time or make me more money?)

All the connections in the world are great, but if you hurt a clinical processes business in the process then that’s going to be a real problem. I’m a huge EHR software advocate. I think every doctor should use EHR. However, if EHR vendors continue to do EHR implementations that have a long term negative impact on EHR productivity, then physicians will continue to resist EHR software in their offices.

The good news is that I’m seeing more and more EHR vendors focused on maintaining and improving the productivity of an office during and after an EHR implementation. I hope that trend continues and that all EHR vendors become fanatical at maximizing the efficiency of a practice during and post EHR implementation.

New EMR Vendor Support

Posted on December 14, 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.

I recently came across this really interesting comment from Abby Nardo on the DrChrono blog:

Thanks for featuring me. I’m really liking Dr. Chrono, and what I’m liking most is your responsiveness to suggestions. As an early adopter to new technologies, this is often what makes/breaks my allegiance, and you guys are great. If you aren’t able to respond to feature requests right away, you tell me why or let me know when it’s going to happen. I’m never left hanging. So far, I’m really happy.

This is one of the challenges in selecting an EMR software vendor. If you choose one of the older EMR vendors with a large established client base, then your comments and feature requests often fall on deaf ears. I’m not saying that these larger EHR vendors don’t listen to their customers. It’s just that they’re getting messages from 1000’s of EMR users at the same time and so you have to work a lot harder to make sure that your request is heard above the noise of the other 1000 voices that are shouting at the same time. Even with only 100 EMR users it’s hard for an EMR vendor to be able to really give personalized attention like is described above by Abby.

As a new entrant into the EMR world DrChrono and other new EMR software have this to their advantage. Since they only have a few customers, they can be very responsive to those customers in ways that a large company never could do. Part of it is what I described above (ie. lack of noise), but the other part is that DrChrono is still really actively developing the features in its EMR. Older EMR systems have likely already built the features that DrChrono is just now getting requested. Some consider this an advantage and some consider it a disadvantage.

Turns out that this is a perpetually cycle. Assuming DrChrono lasts, one day they’ll be the entrenched player and some other company will come along that can be more responsive to customers for the same reasons that DrChrono can be responsive today.

Which is Better?
I’m sure some people are then asking, which option is better? Is it better to have a more responsive EHR company or an EHR company that already has the EMR features that I need?

My answer is that it likely depends upon the nature of the clinic. Certainly you want to be really careful adopting any EHR that doesn’t have essential functions that you need in your office. However, after those baseline features, it depends how involved as a clinic you want to be in the future development of the EHR software. Most providers that I know don’t really want to actively participate in the development of the EHR software. They just want to open the box and have it work. However, for those few who really want to play an active role in shaping the future of an EMR, working with a smaller company can really produce great results for their clinic.

Small EHR Vendor and Specialty EHR Vendor Rant

Posted on November 2, 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.

The following was a comment made on my previous post about Meaningful Use attestation issues by Jon (man there are a lot of John/Jon’s in Health IT). As always, I do my best to bring out interesting topics for all to read. In this rant, Jon makes some interesting comments about the challenge of specialty EHR software to meet the MU measures. Something I’ve mentioned before, but Jon adds some more insight.

*start rant*

It is even worse for some small EHR vendors that have existed for over 20 years – like the one I work for. The government has no idea how ugly and not applicable many key elements of meaningful use (defined as the government chooses) are for non-primary care, highly specialized providers.

Here’s a conundrum that frames EHR certification and meaningful use in a way I rarely see it discussed (and would love for someone to explore more *hint hint*) – take a small, but established vendor of EHR software which is not yet certified.

This vendor provides software to a niche industry of highly specialized providers, who do not derive any real or identifiable value from meaningful use as it is defined (to keep things generic I will omit the specific part of the industry).

To get software 100% EHR certified you must fulfill all of the requirements, even if, as a vendor, your customers will not make use of, or benefit from, most of the functionality. Please take as an assumption (for this discussion) that only 30-40% of the EHR certification requirements are of value to the customer.

Since the customer will not make use of the functionality, they don’t want really want to pay for a 100% EHR certified product. But they sure would like the incentive money (or in the case of Medicare providers, will get penalized if they didn’t do meaningful use).

As a small vendor, your big competitors are all EHR certified (and some are even free), but even if it didn’t make sense for the customer – because the other (typically larger) vendor can afford to implement it, even if it is sloppy. Customers see a well-known product name from a large company is EHR certified – so EHR certification gives those who complete it an edge – even if it makes zero financial or functional sense.

I hate being a pessimist, as surely some good has come from meaningful use. However, as we are seeing by these posts, what value does EHR certification and meaningful use TRULY bring to the provider, other than the requisite piece of paper to get incentive money? We need to see many, many more successes, and in my specific case, we need to make sense of how to make something which is not useful… useful somehow.

Sure, the answer to this might be that in the long run, vendors with better or more applicable products will always win out, but we know that this isn’t always true based on long-term software contracts or lack of desire to switch vendors. Or the answer might be that highly specialized providers only account for 20% or less, and 80% of the provider population is primary care or similar handle meaningful use just fine. Or maybe that I’m just crying in my beer!

Nevertheless, we have this catch-22.. or an enigma wrapped in a mystery shrouded in a riddle.

*end rant* Comments? Thoughts?

One other note from John Lynn, I’m sure many large EHR vendors will probably say that if small EHR vendors can’t meet the MU requirements, then they don’t deserve to be an EHR software. Those that say this, are really missing the point. It’s not that they couldn’t meet the MU requirements, it’s a question of should they meet them in MU’s current state.