Parallel universes–replacing one EHR for another

Some providers are changing their EHR system.  Why?

Why indeed?  What precipitates the need to change?  I bet if you take the top five or seven EHRs, and compare them to a rigorous set of requirements you will find they all score within one standard deviation of the norm.  You won’t hear that from the vendors, but they are the same with regard to the major functionality.

There is no single vendor who scores head over heels above the others.

I bet if you interviewed their customers you will not find a customer which thinks their vendor is the be-all end-all of healthcare.  In fact, you will learn at best most clients will score their satisfaction with their vendor mediocre. Depending on what numbers you read, you will see failure rates in excess of fifty percent.  Failure, by my metric, has more to do with what someone did or did not do to the application than it has to do with the application itself.  This is a “Do these pants make me look fat?” issue.  Guess what, it’s not the pants.

Is there a single vendor who can state that none of their clients has ever replaced them with one of their competitors? That means if you are thinking of replacing EHR A with EHR B, another hospital is thinking of replacing EHR B with EHR A.  Parallel universes, or is it universi?

The grass will not be greener.  Here is what will.  A lot of hospitals operate with what can best be described as anything but best processes–worst processes.  No EHR can handle those.  Before you begin again, evaluate your processes. Weed out the bad ones, do away with the duplicates.

Are you willing to spend another hundred million or two hundred million dollars to get marginally higher satisfaction? Instead, how much would you have to spend to change your processes, implement a change process, retrain your people, and devise a system to bring in your ambulatory doctors?  It would certainly not exceed nine figures.

EHR need not be a do-over.  For those just getting started, do process prior to implementation, not after.

It’s not the pants.

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4 thoughts on “Parallel universes–replacing one EHR for another

  1. This may be true for hospital EMRs where the barrier to entry is huge and no vendor ever dies.

    In the ambulatory market there are good reasons to switch. People either dump an old EMR that never kept up with regulations and innovation, or a rather new and cheap EMR that they fought with for a year and the promises never materialized. Whenever a large financial investment was made, and one of the leading vendors was chosen, people tend to stay the course.

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  2. Your pants theory is a good one. By replacing one EMR for another, providers will most likely find that the same or bigger headaches exist with the new vendor. Changing the dress on the girl does not necessarily make for a new girl. The purchase cost, implementation costs and additional IT staff to accomodate the change will most likely not provide the expected benefit. Perhaps healthcare executives should evaluate their processes first. Think about the way work is done, not making your people work to accomodate the technology.

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