Is Ahab’s search for the great white whale a metaphor for the pursuit of knowledge and his quest for answers?  (Just how far can a former mathematician press his luck when it comes to interpreting classical English literature?  Evidently, not very.)  As Ahab continues to scan the surface of the ocean, the ocean’s surface becomes a metaphor for a search for revelation—I think we’ve milked this as far as we can.  Are we in turn able to adapt that metaphor to the quest for revelation for the best EHR for your organization—before answering, it may be helpful to recall that the odyssey undertaken by Melville’s Ahab became apocalyptic–he first lost his leg and then his life to the whale—not encouraging for all of us who may be part-time whalers.

So, where were we?  There are those who think they have successfully completed their quest, found their revelation and either implemented EHR or are in process of doing so.  They may be right.  That’s not for me to judge without any personal knowledge of your effort.  Published data about the failure rate of EHR implementations, paired with the failure rate for EMR implementations, strongly suggests that the determination of “completion” may not be up to the implementer.  “Completed” projects were done without final standards and without interoperability certification.  That can mean only one thing; Moby Dick still lurks beneath the surface.

Given present circumstances, is there a “best” EHR for you, or are you equally well off tossing EHR vendors at a dart board—you may have to sharpen them because sometimes they don’t stick.  Each organization likes to think of themselves as different from the others.  In some respects they are.  However, hospitals and clinics aren’t like fingerprints.  They are similar enough in some major areas of their business whereby it should be fair to draw comparisons.

Assume for a moment that your hospital is similar—by whatever definition you choose—to three other hospitals that have implemented or are implementing EHRs different from the one you selected.  The obvious question is why, why the difference?  Did both hospitals get it right?  Is your hospital’s choice correct and theirs wrong?  Is there a good, better, best ranking?  If so, what business benefits will your hospital’s EHR sacrifice.

The point of this entire discussion is the following:  It’s not about the EHR, it never was.  It’s not an IT decision, it never was.  The EHR is a healthcare tool.  Its singular purpose is to enable your hospital or clinic to radically transform its business.  If it can’t do that, it’s time to select another tool, or retool the one you have.