My post yesterday on EMR and HIPAA called “Does Spending More on EHR Mean You Get More?” started me thinking what does differentiate one EHR company from another. I think there’s a real disconnect between what most people selecting an EHR use to differentiate EHR companies with what really matters to the users of an EHR.
First let’s take a look at some of the many ways that I see doctors and hospital CIO’s using to differentiate EHR companies. Many use price as an indicator of quality. Hopefully this post puts that to bed. Price matters, but it’s not a great indicator of EHR success. Many are swayed by great sales and marketing by EHR companies. It’s hard to deny that seeing an EHR vendor with a full HIMSS booth doesn’t have some effect on what you think of that EHR vendor. Going along with this is having the big, well branded name recognition. Although, what’s in a name if the EHR software doesn’t meet your specific needs?
Another differentiator that many use is KLAS or other ratings. When I’ve dug into all of the various EHR rating and ranking systems, there are flaws in all of them. Some lack enough data to really draw conclusions. Some use bias methods for collecting data. Some EHR ranking services don’t use data at all. It’s amazing how interested we get in a list that may or may not have any legitimate value. Every EHR vendor has some flashy numbers to share with you. Just remember that numbers can lie. You can make them appear any way you want.
I’m a little torn on the idea of EHR certification and access to EHR incentive money being a point of differentiation for EHR vendors. There are so few that can’t get you there, that it’s almost a non-issue. Sure, if you really want to get the EHR incentive money, you could and should talk to the users of that EHR that have gotten the EHR incentive money. However, because almost every EHR vendor is a certified EHR that can get you to meaningful use, not being certified might actually be a more exciting. The story is reasonable: our EHR focused on what doctors care about in an EHR as opposed to some random government requirements. Could be a compelling message. Especially for those doctors who don’t qualify for the EHR incentive money.
What should be used to differentiate EHR companies?
The number one thing that I think doctors should look for in an EHR is efficiency. A large part of the coming Physician EHR revolt is due EHR software’s impact on physician efficiency. Yet, most doctors selecting an EHR pay little attention to the effect of an EHR on efficiency. This data is harder to get, but a good survey of existing EHR users can usually get you some good information in this regard.
Another area of differentiation with EHR companies should be around their EHR support and training. How quickly an EHR vendor answers support requests and how well an EHR gets you up and running on an EHR is extremely important. As someone on LinkedIn mentioned today, EHR is not plug-n-play software. There’s more to an EHR implementation than just plugging it in and going. It requires some configuration and learning in order to use an EHR in the most effective way.
How come we don’t use the quality of care that an EHR provides as a method of differentiating EHRs? The answer is probably because it’s a really hard thing to measure. I wonder if any EHR has found a way to show that their EHR provides better care. There’s plenty of anecdotal examples, but I wonder if anyone has more data on this.
Another point of differentiation that I think matters is how an EHR company approaches its relationship with the users. Does the doctor, practice and hospital feel like a partner of the EHR company or are they a distant customer. You can imagine which situation is better than the other. This relationship will matter deeply as you run into problems that are unique to your environment. I assure you that this problems will come.
I also see technology approach as a really important factor for EHR companies. When I say this, I think most people start to think about SaaS EHR vs Client Server EHR. Certainly that is one major component to this idea, but it should go much deeper. You can tell by the way an EHR’s technology approach if they’re focused on the right things. Do they take shortcuts when they implement technology? Are they thoughtful about what really matters to the EHR user? Do they implement something on a whim or do they think deeply about the impact of a feature? While every EHR company has limits on what they can put out in a release, they can still provide a great roadmap of the current release and their plans for future releases which shows that they understand the needs of the users.
I’m sure there are many more good ways to differentiate an EHR company. I look forward to hearing more of them in the comments. We just need to expand the discussion to things that really matter as opposed to basing our EHR decisions on vanity metrics.