Failed EHRs: Maybe it’s the jeans

There I was listening to NPR while driving home from the airport.  Their lead story was about Levis’ announcement of a new line of custom-fit jeans for women.  They developed the line after studying the shapes of more than 60,000 women—I guess that is good work if you can get it.  Levis somehow determined that 80 percent of all the women on the planet fall into three distinct categories, Curve IDs.  (Does that mean the other twenty percent fall into roughly 3,752,841 body types?)

Why did Levis go through all this effort?  Apparently 87 percent of women say they can’t find a pair of jeans that fits them.  Fifty-four percent stated they try on at least ten pairs of jeans before deciding on a pair.  I concluded from a few of the things I read on Google that for those whom believe the jeans don’t fit—must be a lot of bad jeans out there.

There are a lot of failed EHR implementations out there.  How do I know that to be true?  I studied the shapes of more than 60,000 failed EHR implementations and, guess what?  They fall into three failure categories—EHR Failure IDs—lack of due planning, lack of process change, and lack of user involvement.  I guess it’s difficult to get an EHR to fit…Kind of like finding a good pair of jeans.

Here’s my take on the matter.  Chances are that whatever EHR does not seem to fit in Provider A is fitting just fine at Provider B.  How could that be?  Same system.  Same code.  The functionality of the system has not changed in the time since it was selected.  Maybe the reason the EHR does not fit is not the fault of the EHR.

That said, there are those of you who think I may tie this discussion back to the discussion of the jeans, and write something like, “Maybe the reason the jeans do not fit is not the fault of the jeans.”  I may be dumb, but I am not that dumb.
Kind Regards,


Paul M. Roemer
Managing Partner, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942

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4 thoughts on “Failed EHRs: Maybe it’s the jeans

  1. Pingback: ICMCC News Page » Failed EHRs: Maybe it’s the jeans

  2. 100% agreed and the reason I have been looking and bothering me why the implementation is taking time and almost impossible, why there is need for Government to pay the money in the form of incentives to get EHR implemented.

    After putting hours and days of thinking the conclusion and bottom line was same, which came into my mind at first hour, that government and EHR vendors are putting and designing and implementing the requirements what fits and look good to them, they don’t really look what into patient care and physician’s need to save the time and spend that time on patient care, they are just working on data collection for now not exactly decision support systems, which can save time of every health-care provider, so they can see more patients and save more…..!


  3. EMRs, like jeans, have particular features that must work together as a unified whole in order to satisfy users. Although there are a good number of EMRs available in the market, the core features are essentially the same. The difference comes in the form of robustness, ability to fit the presented use case, adaptability to multiple user environments. Sort of like jeans.

    I think the failures are certainly, as Paul said, due to inadequate planning, process change and/or user involvement. However, the latter two are themselves elements of planning. The planning should clearly establish the process change and user involvement necessary for success and attainment of cost and productivity goals. Stakeholders will either buy into these elements of the plan or the implementation should not happen.

    So, I believe the root cause of the majority of EMR implementation failures is poor planning. Further, the poor planning may be the result of enterprises trying to venture out into an unknown area, such as EMR, on their own. Or possibly, having total reliance on an EMR vendor to provide the planning and insight to perform the implementation properly. Often times, the vendor will take a cookie cutter approach — one EMR fits all users — which may be cost efficient for the vendor but does not address the real-world needs of the stakeholders and users.

    There is no alternative to proper and thorough planning when it comes to EMRs.


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