According to the New England Journal of Medicine, somewhere north of fifty percent of EHR implementations fails. Your odds of success are no greater than the flip of a coin.
What if there is a tool whose use can stop the failure of most EMR system implementations? The purpose of this post is to let you know that there is a definitive solution to help small providers, clinics, IPAs, and hospitals.
What tasks of the EMR process is the primary cause for failure? They are the tasks that are under budgeted, neglected, haphazardly addressed, or addressed by people who have no earthly idea how to perform them.
They are the same tasks that cause systems projects in other industries to fail. If you do these tasks wrong, nothing else you do will make any difference—do-overs cost twice as much as your first failure.
The laundry list of those tasks is:
- Defining your requirements—for physicians, nurses, staff—all of them.
- Putting those requirements into an operable framework.
- Ranking the requirements in a way to enable you to pick a good solution.
- Technology Evaluation
- Clinical Workflow Evaluation – Analysis of current clinical workflows.
- Gap Analysis – Comparing current technical capabilities to desired capabilities.
- EMR/Practice Management needs evaluation
- ARRA Incentive Estimation
- Qualified EMR vendor list
- Vendor competitive bid assessment
- Hardware requirements
I recently asked a hospital CEO, “What would you have done differently regarding your EHR selection?”
Here is a paraphrase of his response.
- Invested much more time in understanding what system we should select and how we would use it.
- My peers assumed someone else had already done all the up-front stuff (see the above list), and they selected their system solely on what others were using. Alternatively, they picked a system based on a golf course conversation or something they saw at a trade show.
How many of your business and clinical requirements do you need to meet for your EHR selection to have any chance of succeeding? The best answer is “All of them”. How many requirements are needed to define your needs; one hundred, two hundred? Not even close.
Try this exercise. Search Google for “CRM RFP” or “ERP RFP”. There are hundreds of useful responses. Now search Google for “EHR RFP” or “EMR RFP”. There are no useful responses. (If you cannot find something on Google, it often means it does not exist.) The healthcare industry is usually very good at sharing useful information.
I’ve been coaching executives for thirty years about how to get these tasks right. In doing so, I developed something that made the software selection task winnable. (This piece is not a Tony Robbins narrative, it is not about me; I am not selling anything.)
Here is what I did. I built a Request for Proposal (RFP) for CRM and ERP. I started with 1,000 requirements for each. I license it to clients and work with them to edit it, to add new requirements, to delete requirements that did not apply to their organization. They would use the result to select the application best suited to their firm.
This process never failed to benefit my clients. I would take whatever new requirements they created and add them to my RFP. My RFP became more robust. Each time the RFP was issued I collected the responses from each of the vendors and built a database of what their applications could deliver. I now have a few thousand functional and technical requirements, and up to date responses on what the applications vendors could deliver.
Why did I build this RFP? The answer is simple. I needed to create a reason for a firm to hire my firm instead of hiring one of the name-brand multi-national consulting firms. The RFP served as a cost differentiator. Instead of spending a million dollars to hire a name-brand firm to develop something from scratch, they could be months ahead, and at a lower cost by using a proven tool.
Therefore, here’s my point. There is a firm that built a tool similar to mine, a tool to add to the probability of you selecting the best EMR/EHR for your firm. It will not guarantee your success, but it will significantly reduce the chances of failure.
Clearly, even if you select the right system there are still many opportunities to fail. The converse is that if you select the wrong EHR, it will fail. That statement is not an opinion; it is a fact.
I’ve arranged a Go-to-meeting conference call with the CEO of that firm for the week of July 26. This organization has built what I described; an RFP with more than a thousand unique requirements, an automated way to analyze the vendor responses, and a way to match your prioritized requirements to a short list of EHR vendors. It will not be a sales pitch. It is designed to be a question and answer session. Who should participate?
- Smaller providers whose only other option is to hire the person who set up their web site to manage their EMR selection
- IPAs whose members are looking for advice about selecting a system to meet their specialization
- Hospitals struggling with finding a defensible position for their selection.
If you are involved in the selection of an EMR/EHR, you should find an hour to assess the tool. If you do not have the resources to make use of the tool, they do. They can help you help yourselves. I promise you, this will be the best use of sixty minutes you have had in a long time. If you know someone who might benefit from this session, please forward this and have them contact me. If you could benefit, simply respond to me.
Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy
1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
A thousand requirements for small private practices is a bit much. There are plenty EHR RFP/RFI/RFQ out there, maybe not on Google for some reason, but they are there. I have a very good one, if I may say so, myself.
There are currently 60 RECs issuing RFPs. Some are already out there and some are in the process of being constructed. I have seen some of those and they range from the classic outdated DOQ-IT to some pretty good stuff (I still like mine better :-))
Most small practices do not issue RFPs, but IPAs and very large groups most certainly do. Filled quite a few of those when I was on the vendor side. It’s not the lack of RFPs that makes projects fail. It is the lack of planning and change management.