Thoughts on Walmart, eCW and Dell EHR – A Doctor’s Perspective

Posted on March 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 promised, I wanted to share a few thoughts about the newly announced Walmart EHR package. I previously posted a nice summary of how the Walmart, eCW and Dell EHR will work. If you’ve never heard about the Walmart EHR, then go read that post and come back.

Offhand it would be really easy to criticize this move by Walmart (really Sam’s Club). I can just imagine doctors going down the aisle of Sam’s Club: toilet paper, candy bars, EHR software, oh yeah, I almost forgot the salsa. Honestly, does that sound right to anyone?

However, I’m certain that many people said the same thing about getting TVs, vacation packages and tires at Sam’s Club when they first started offering those items as well. Toilet paper, candy bars and disney vacation doesn’t sound much better.

All of this said, I still think the idea is crazy. I’m not talking about Walmart, eCW and Dell being crazy. I’m saying that any doctor’s office that chooses to buy this package at Sam’s Club is crazy. Let me explain.

I’ve often talked about your EHR becoming the life blood of your practice. Once you’ve implemented an EHR it becomes apart of almost everything you do in a clinic. I can’t think of any part of a clinical practice that isn’t affected by the implementation of an EHR. Doctors spend as much time on their EHR as they do helping patients.

Yes, I know it’s a sad reality, but it’s the reality. Other people might tell you different, but I don’t think they’re being very honest with you. Is this reason for concern? No, because you could have just as easily said that Doctors spend as much time in paper charts as they do helping patients. Why this is the case is the topic for another post. The point is that the EHR becomes the center of a practice. Still don’t believe me? Watch for a future post on the topic which will include more compelling reasons EHR’s the core of a practice.

Since EHR is the core of your practice, do you really want to get your EHR package at Walmart?

Seriously, think about that. You’re trusting your livelihood and happiness (yes, EHR affects both of those things) to a $25k package you bought at Walmart?

I’m not saying that eCW, Dell and Walmart aren’t great companies. eCW has an EMR product that’s been very successful and is an EMR that many should and would consider for their clinic. I love Dell products and recommend them to anyone. I just don’t see why you’d purchase it at Walmart instead of going directly to Dell and eCW.

Let’s just think this through. First, I’d expect that if I’m buying this EHR package through Walmart, then I’m getting a better deal than if I bought each of the items separately. This means less revenue for eCW and Dell from the start. Next, you take out whatever Walmart’s getting paid to make the sale. The question then remains, how can these companies sell their products cheaper than normal AND share the revenue with Walmart? The answer is easy. They’re going to find other ways to lower their costs.

Let’s think about ways that they can lower your costs:

First, they should have saved money trying to sale you the product.  In theory this is great.  Walmart’s taking care of the marketing and sales of the product, so that’s why the product is cheaper.  Of course, the doctors should be asking themselves if they want Walmart to be the one showing them how the Walmart EHR will work for them.  Ahh, but certainly Walmart won’t be the ones demoing the product to the doctors.  eCW will be taking care of all the demoing and “sales” of the product.  Well, there goes the money eCW was saving by using Walmart.   That basically relegates Walmart to a lead generated for eCW.

Second, eCW could enjoy economies of scale as they support more istances of EHR.  Let me translate what this means for you as a doctor: POOR Support.  Try supporting 25k physicians (number using eCW per NYTimes) spread across the country in every specialty imaginable.  It’s pretty much impossible to expect that eCW could provide personal and quality service to such a large user base.  Just think about how many people eCW would need to hire and train to be able to provide the type of support you’d like to receive if you’re a doctor implementing an EHR (eCW is hiring for those searching).  I’m pretty sure that calling them and telling them that you bought your EHR at Walmart is going to put you at the front of the support line.

EHR vendor support is so important to having a successful EHR implementation.  I’m familiar with a large eCW implementation that was having troubles getting the support they needed.  It seemed that this was probably due to the popularity of eCW.  Credit the eCW sales team for doing a good job selling the product, but if I’m a doctor I’m not throwing my ring into an EHR vendor that can’t support me because they’ve oversold.  Considering you’re buying a cheap (isn’t that Walmart’s motto?) Walmart EHR, don’t expect World Class support when you’re paying Walmart prices.

I could keep going with thoughts about this announcement.  Suffice it to say that from a doctor’s perspective I think you’d be crazy to take it.  Now, if separately you’ve made a decision to choose eCW and the Dell computers they offer and you can get it cheaper at Walmart, great.  However, what are the chances of that happening?

There’s so much more that should be said about this topic.  I’ll be following up with another post tomorrow about the Walmart EHR from an eCW and Dell perspective.  I think you’ll enjoy that post.

I probably should have also mentioned that eCW does have a strong community of users that can be leveraged for support as well.  The point of this post isn’t to lower eCW or Dell in particular.  This could have been any EHR software vendor and hardware vendor and I’d have said the same things.  And yes, I’m still very excited to try out the 2 new Dell dual touch tablets I ordered yesterday.

One final parting thought: if you buy the EHR package at Sam’s Club, does the Sam’s Club return policy apply?  Now that’s something that could change my mind.