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EHR Change Doesn’t Always Mean Better

Posted on August 1, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In the comments of my post “EHR Replacement Roadmap to Success“, John Brewer provided a great reminder that changing EHR software doesn’t always mean that you’ll change to a better EHR. You might change to something worse. At least that’s my summary of his comments. You can read his full comment if you want.

I’ve learned this lesson over and over in my career. Sometimes you need to be content with what you have. One example of this was when I was working at a University in Hawaii. I was quite disappointed with the CIO and thought that he could do a lot of things different. Well, I got my wish and the CIO was replaced with someone else. Considering the topic of this blog post, you can imagine what happened next. The replacement CIO was so much worse than the previous CIO. Lesson learned.

Change doesn’t always mean a change for the better. It can certainly mean a change for the worse.

This applies fully to EHR replacement, which is quickly becoming a hot topic as many people regret their EHR purchase decision. You do need to be careful that you’re so afraid of change that you never change. In many situations change is the right decision. Plus, unlike my story where I had little control over who was hired as the new CIO, when you switch EHR software you can have some impact on the selection and end results. In many cases, you might even discover that you shouldn’t switch EHR before it’s too late.

I expect most people who think they need to switch EHR need to be careful to not set a predetermined course early in the process. Instead of saying, “Which EHR should I switch to?” I believe that many should dig deeper into the question, “If I switched EHR software, what would improve?”

As I replied to John Brewer in the post linked above, it is often (but not always) the case that the second EHR selected goes better than the first. I’ve found that the first “failed” EHR implementation usually teaches some great (albeit costly) lessons that they’re able to avoid the second time around. However, there is a tendency the second time around to focus too much on the first EHR issues that can cause different trouble the second time around. As in most things, there’s a balance to be had.

My best suggestion is to not do anything too impulsive. Let the idea sit and germinate a little before you do anything too drastic. Emotional decisions with EHR software selection (and quite frankly many other decisions) often leads to bad outcomes.

EMR Purchasing Question and Answer

Posted on June 2, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I always like it when people ask me questions about EMR. That way, I know that I’ll be providing at least some value to someone. Brian asked the following question in the comments:
Do you know who actually makes the decisions to purchase EMRs? For example, at large hospitals or medical groups, is it CIOs, and in small practices is it physicians?

This is a really hard question to answer. In fact, it’s likely one of the reasons why making the EMR sale is pretty hard. Each organization is very different. I guess this is a byproduct of the capitalist society that we live in.

That said, in hospitals, it usually is the CIO that is making the final decision to purchase an EMR after the CEO’s approval of course. Although, many times the work of selecting the EMR software and going through the EMR review process is delegated to a committee of people in the hospital organization.

The medical groups are harder to analyze since they come in all shapes and sizes. Not to mention varying governance structures. I would likely define these practices in two categories: physician run groups and manager run groups. You can guess who makes the decisions in these two categories. With that said, the doctors can really make an EMR implementation miserable if they’re not on board with the EMR selection. So, even if the practice is not physician run, you better consider these doctors in the process.

Small groups are generally more heavily influenced by the physician’s choices. Occasionally you’ll come across a strong practice manager, but usually that person is strong because they know how to work well with the doctor and their needs.

Certainly there a lot of other variations, but this is generally what I’ve seen.