EHR choice


The Devil In The Details When Choosing Your Own EHR

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EHR choice

When it comes to electronic health records, choice is good, but can be very challenging.

As it is now, many providers feel they don’t have the option to choose their own, and instead go with the most well-known or with the one their colleagues use.

Thinking outside the box and choosing a different EHR product can create security and privacy headaches, since interoperability often hasn’t been established by the differing vendors yet. But the benefits of connectivity seem to be luring more and more providers to a “choose your own” model.

The Chief Information Officer of Inspira Health Network in New Jersey recently revealed how their ground-up information exchange system successfully linked three hospitals, 5,000 employees and 800 doctors, using 36 different EHRs.

There seems to be a consensus forming: building these connections is a lot of work, but especially for ambulatory practices, that effort is worthwhile.

HealthBiz Decoded spoke to Dan Stewart, Vice President-Practice Partner, Strategic Advisory Services, Xerox, to learn why this could be a good model to adopt now to avoid more problems in the near future. In his mind, choice is a good idea, but many physicians don’t have the expertise to make that choice.

“I think everyone agrees that provider choice in selecting electronic health records, … from a physician practice perspective, is the way [you] want to go,” Stewart told HealthBiz Decoded.

“In general, they should be able to choose their own EHR, but right now there is a lot of risk doing that,” he said.

If you choose the wrong one, or chose one that quickly goes under (which these days is likely) you could find yourself starting the arduous process all over again. And uprooting one system to replace it with another is no picnic, Stewart said.

“There’s been a huge turnover in ambulatory EHRs. With the ones implemented in 2010 [and] 2011, satisfaction was so low,” he said. “That gives you an idea of how frustrated some of these doctors are, if they’ll switch out, considering how difficult that is.”

This year, and in the coming years, Stewart predicts the current pool of more than 500 ambulatory EHR vendors in the U.S. will be whittled down to a handful, especially as interoperability and functionality standards emerge with Meaningful Use stage 2. The lack of those standards so far led to the current debacle: many different systems designed without standards for communicating and working together.

“A lot of mom and pops are going to go out of business,” he said.

The money crunch of continually changing EHR systems gets even more dire when the Meaningful Use incentive for adoption doesn’t cover the cost of the system itself, which is often the case, he said.

That makes choosing your own EHR a risky proposition, but the right choice can pay off in the long run.

Ideally physician practices would consult a third party expert for help in choosing the system that best fits their practice, Stewart said.

For those who don’t have access to a consultant, here are some tips for picking the right EHR. First, consider the product:

  • How much does it cost?
  • Does it have the functionality you need? Certain products are better for primary care doctors and other work for specialists, Stewart said.
  • Will you need to train people to use the new system? Will that cost more money?

Also, consider the vendor.

  • How big is the company? Are they likely to be acquired by a larger one? If so, best to go with the larger vendor and avoid changing systems later.
  • How long have they been in business?
  • How many clients do they have?
  • Do they have clients in your specialty?

“Don’t just pick something because your buddy in another practice likes it,” Stewart said.

As more and more physician practices and small rural hospitals are acquired by large urban hospital systems, a growing trend in the U.S., those small practices are forced to adopt whatever EHR the larger system uses to facilitate information transfer. That can lead to expensive, time consuming turnover and frustration. Be aware of where your practice stands in that volatile landscape, Stewart said, and plan accordingly.


*This story has been updated to reflect changes to Dan Stewart’s comments.