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Balancing EHR Change vs Train

Posted on May 21, 2013 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 was talking with Heather Haugen from The Breakaway Group (A Xerox company) today and in our discussion she used the word “train”, but I heard the word “change”. I always love a good play on words and so it was interesting for me to consider the difference between change and train in an EHR implementation.

Every EHR implementation I’ve been apart of walks a fine line between users wanting the EHR software to change versus the need for an EHR user to change. One of the most common phrases out of a doctor’s mouth during an EHR implementation is, “Why did the EHR vendor implement that feature like this? Did they not talk to a doctor? This makes no sense.” We’ve dug in previously to the concept of EHR vendors consulting doctors during their EHR development so we won’t go into that further now. Every EHR vendor consults doctors, but no two doctors practice alike. So, it’s normal that every doctor would wonder why certain features are implemented the way they are implemented.

When faced with this issue, the doctor is faced with an important decision with two options. The first option is to work with the EHR vendor and convince them to change how their EHR works. In a large hospital EHR vendor situation, this can be almost impossible. Plus, even if that EHR vendor does like your suggested change it’s going to take months and sometimes years before that change is implemented in the EHR software, tested, and released all the way to you the end user. Yes, these changes can go faster with a SaaS EHR, but it still will likely take months before the change reaches the end user.

In some cases, you can wait for the change to be made before using that EHR feature. However, more often than not a doctor is going to have to train on how the EHR vendor has implemented the feature. This highlights to me why having great EHR training is so important. Sure, many of the things in an EHR will be intuitive, but great EHR training is still always beneficial. EHR software is too complex to just pickup and use. Plus, even if you can use the basic EHR features, good training points out the ways to optimize the EHR workflow.

Most doctors don’t understand why various parts of an EHR workflow can’t be easily changed. They just think change should happen easily. Ironically, the doctor then proceeds to resist any change to how they want to work.

A Couple Initial NextGen User Group Meeting Observations #NextGenUGM

Posted on November 14, 2011 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.

Today I’ve had the opportunity to come and check out the NextGen user group meeting. It was conveniently located in Las Vegas and the PR people at NextGen were generous enough to let me come by and get to learn more about NextGen from their actual users. I’ve gone to a lot of healthcare IT conferences (too many recently), but I love to be at user group meetings since you actually get to meet doctors, practice managers, etc that are working on EMR day in and day out. They provide a much different perspective than the health IT industry people that you often meet. Events like this give me a much better perspective of what’s happening in doctors’ offices with EMR.

NextGen announced 4200 in attendance at the user group meeting and I can attest that it’s a very large crowd. It’s quite interesting that the opening keynote was held in the same arena that Pacquiao vs Marquez was fought in a couple nights ago. Yep, that’s a pretty big crowd. Turns out, this big of crowd has its challenges. Not the least of which is having a bunch of the sessions that were completely full and didn’t allow people in. I heard at least one person tell me how frustrated they were that they’d spent a lot of money to attend and couldn’t go to the session they wanted. NextGen is working to offer a repeat of the session, so hopefully that will work out for people that are upset. A part of me wonders why they don’t record all the sessions, but when you read their social media policy for attendees (Something about not revealing NextGen’s proprietary info) you get a better idea of why they wouldn’t probably like that idea.

I could go on about the particulars of the conference, but so far it’s been a well organized and well attended event.

One quick thought I had during the Scott Decker keynote was about NextGen’s focus on SaaS based solutions. Here’s what I tweeted:

Those are just a few examples, but it seemed very clear to me that NextGen sees SaaS as the future and they’re working hard to make that a reality. I’ll write about this in a future post when I talk about some of the things Scott Decker mentioned that can really only be done in the SaaS environment.

In some of my talks with NextGen users, I asked them about the theme of web based EHR software. One in particular has 30 Citrix servers serving all of their clients. You can imagine that they don’t have any plans to move to a web based environment in the near future with such a large investment in Citrix. So, it will be interesting to see how these two forces play out.

I also saw this tweet coming out of the conference which I found really interesting:

It’s an interesting way to look at EHR adoption. Little insights like this are a really great part of a conference like this. The nice thing is that with the power of Twitter, you can get a number of the insights from the user group yourself. Just follow the hashtag #NextGenUGM.

EHR In the Cloud – Major EHR Developments per Halamka

Posted on September 14, 2011 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.

As most of you know, John Halamka is publishing content everywhere. In fact, maybe I should see if he’ll publish some here. Halamka is really smart and respected by many for good reason. So, I was intrigued to find an article in the Technology Review (an MIT publication) where Halamka higlights what he considers the major EHR and healthcare IT developments over the next five years.

I’ve been doing a number of series lately on EMR and EHR & EMR and HIPAA and since people seem to really like them, I decided I’d make Halamka’s major EHR developments into a series as well.

The first Major EHR Development is: EHR In the Cloud

In the article above, Halamka offers some interesting comments about doctors being doctors and not tech people, the issues of privacy in the cloud and hospitals leaning towards “private clouds.” Let’s take a look at each of these.

Doctors Don’t Want to be Tech People
While there are certainly exceptions to the rule, it’s true that most doctors just want their tech to work. They don’t want to spend a weekend installing a server. There’s little argument that a SaaS EHR requires less in office tech. This fact will end up being a major driving force behind the adoption of SaaS EHR software over the client server counterparts.

Certainly, many doctors will still feel comfortable with their local IT help doing the work for a client server install. Also, many still feel more comfortable having their EHR data stored on a server in their office. This issue will continue to fester for a long time to come. At least until the SaaS EHR vendors provide doctors a copy of their data which they can store in their office. Plus, SaaS EHR are much faster today than they were, but there’s still a few things that a client server can do that is just flat out faster than client server.

I still see the ease of implementation and “less tech” helping SaaS EHR software to continue to gain market share.

Privacy in the Cloud
The biggest problem here is likely that doctors aren’t technical enough to really understand the risks of data in the cloud or not. Plus, I think you can reasonably make an argument that both sides have privacy risks. Most people are becoming much more comfortable with data stored in the cloud. I expect this trend to continue.

Private Clouds for Hospitals
Halamka claims that he, “estimates that moving infrastructure and applications to my hospital’s private cloud has reduced the cost of implementing electronic health records by half.” Of course, we have a lot of possible definitions of “cloud” and I’m not exactly sure how Halamka defines his private cloud. However, anyone who’s managed client installs of EHR software, including client upgrades, etc knows some of the pains associated with it. I’d be interested to know what other savings Halamka and Beth Israel Deaconess Medical Center get from their “private cloud.”

Cloud and EHR
There’s one thing I can’t ever get out of me head when I think about EHR and the cloud. Someone once told me (sorry I can’t remember who), “The cloud has always won in every industry. It will win in EHR too.” I hate when people use terms like always and every, but I haven’t (yet?) found an example to prove that person wrong.

SaaS EHR Down Time vs. In House EHR Down Time

Posted on August 9, 2011 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.

As part of my continuing series of posts about EHR Down time (see my previous Cost of EHR Down Time and Reasons Your EHR Will Go Down posts), I thought it would be interesting to look at how a SaaS EHR down time is different from an in house EHR down time.

I’ll use the list of reasons your EHR go down as my discussion points for how it’s different with a SaaS EHR versus an in house EHR. On each point, I’ll see if either approach has an advantage over the other.

Power Outage – Certainly a power outage will impact both types of EHR implementations. If your computer or router doesn’t have power, then it doesn’t matter where your EHR is hosted. However, many clinics use laptops which can run for quite a while without being plugged in. Plus, a small UPS for your network equipment is pretty cheap and easy to implement.

However, a good UPS for your own server will cost a bit more to implement. Plus, the UPS won’t likely last very long. Most UPS are there to give you enough time to power down your system properly or to handle a short power outage. Of course, in this case we’re talking about a small clinic implementation. I have done an EMR implementation where we had some nice UPS and even a backup generator. However, this is the exception.

Conclusion: Slight Advantage for the SaaS EHR

Hard Drive Failure – Certainly the failure of a hard drive in your desktop machine will affect both types of EHR install equally. So, that part is a wash. However, the hard drive failure on your local server is much more of an issue than a SaaS EHR vendor. At least, I’ve never heard of a hard drive failure causing an issue for any SaaS software vendor of any type. Both in house and SaaS EHR implementations can implement redundant hard drives, but SaaS EHR vendors have to implement redundant servers.

Conclusion: Advantage SaaS EHR

Power Supply Failure – This one is similar to the Hard Drive failure. I know a lot of EHR vendors that have their clinics buy an in house server that doesn’t have redundant power supplies. I can’t imagine a SaaS EHR vendor buying a server without redundant power supplies even if the redundancy is across servers.

Conclusion: Advantage SaaS EHR

Network Cable – Cables can get pulled out of switches just as easily as servers. So, I conclude that it will affect SaaS EHR and in house EHR the same.

Conclusion: Tie

Switch/Router – Loss of a switch/router will cause either a SaaS EHR or in house EHR to go down.

Conclusion: Tie

Motherboard Failure – An in house server only has one motherboard. If that motherboard fails, you better hope you have a great tech support contract to get a motherboard to you quickly (For example, Dell has a 4 hour support contract which is amazing, but pricey). Certainly a motherboard can fail for a SaaS EHR as well, but since they likely have multiple servers, they can just roll the users over to another server while they replace the motherboard.

Conclusion: Advantage SaaS EHR

EHR Software Issue – This is a hard one to analyze since a software issue like this could happen on either type of EHR install. It really has more to do with the EHR vendor’s development and testing process than it has to do with the way the EHR software is delivered.

You could argue that because the SaaS EHR is all hosted by he company, they will be able to see the issues you’re having first hand and will have tested on the hardware they have in place. A client server/in house EHR install could be on a variety of EHR systems that the EHR vendor didn’t know about and couldn’t test as they developed and deployed the system. So, I could see a slight benefit for the SaaS EHR system.

However, one disadvantage to the SaaS EHR system is that they are hosting it across dozens of servers and so when something goes wrong on a server it’s sometimes hard to figure out what’s going wrong since all the servers are the same. Maybe that’s a bit of a stretch, but we’ve all seen times when certain users of a service are down, but not others.

Conclusion: Maybe a slight advantage to SaaS EHR

Internet Outage – This one is the most clear cut benefit to an in house server. When your internet connection goes down, the in house server keeps plugging along no problem. Loss of your internet connection with a SaaS EHR is terrible. No doubt that’s often the greatest weakness of a SaaS EHR. Although, it can be partially mitigated with multiple internet connections (ie. wired internet and wireless broadband internet).

Conclusion: Advantage In House EHR

I have to admit that I didn’t realize going into this analysis that it was going to be a landslide for the SaaS EHR. Although, that’s quite clear from this analysis. When it comes to EHR down time, the SaaS EHR is much better. Unless, you live in an area where the internet connection is unreliable and slow. Then, you don’t really have much choice since SaaS EHR needs a reliable internet connection.

It’s also worth noting that this article only talks about how EHR down time relates to SaaS EHR versus in house EHR. There are certainly plenty of other arguments that could be made for and against either implementation method such as: speed, privacy, security, cost, etc.

Mobile Makes the Difference in Emergencies … or on Vacation

Posted on August 3, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

My family and I have escaped this week to our favorite vacation destination, Pensacola Beach. And so I sit here writing in the cozy confines of the condo that we call home for close to a week nearly every summer. I gave barely a thought to how I was going to transmit this blog to the HealthcareScene.com servers while here. As it turns out, there is no WiFi, which means I’m relying on my iPhone to do a bit of online research, my laptop for Word, and the hotel across the street’s business center with which to cobble it all together.

My connectivity issues pale, of course, in comparison to those of providers working outside of their hospital’s four walls – be it in emergency situations such as the aftermath of a hurricanes like Ivan and Dennis, which hit Pensacola back in 2004 and 2005, respectively, or as part of a routine provider/patient encounter in telehealth programs. I wonder how providers at Pensacola’s Sacred Heart Hospital, where I was born (and no, I’m not telling you what year), handled patient care in the aftermath of Ivan, which devastated the town and outlying beach communities, and how mobile health solutions might better enable them should Mother Nature pay the same sort of visit today.

Well timed for this blog was the recent news that Epocrates has released the first phase of its EHR system, including an iPhone app, targeted to primary care practices with 10 physicians or less. The EHR, according to a recent report at MobiHealthNews.com, “is initially available as a Web-based SaaS product, includes patient encounter notes, electronic lab integration, e-prescribing and Epocrates’ flagship drug database.”

The iPhone version should be available in a few weeks, and is likely to include remote patient record look-up and schedule access, and e-prescribing. The iPad version, which is in development, will focus on point-of-care data capture. MobiHealthNews.com also reports that an Android app is in the works, but will be rolled out in later versions of the EHR.

It will be interesting to see if later versions also target larger physician practices, which would surely also benefit from mobile technology like this. Perhaps most interesting, at least to providers in places like Pensacola that see their fair share of hurricane-induced on-site emergency care, is that the Epocrates mobile EHR app will “be a native app and it will store patient data on the device,” according to the company, which means that “the device will not need a signal to access the EHR. Any new data will be synched with the record once the phone finds a signal.”

Hopefully that signal will not be as elusive in a community’s time of need as the WiFi seems to be at my vacation destination.

Reasons Your EHR Will Go Down

Posted on July 26, 2011 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.

My previous post about the cost of EHR down time prompted me to think of all the ways that your EHR can go down. This might not be an exhaustive list, but hopefully it gives you an idea of the many many ways that your EMR can go down. With that knowledge hopefully you’ll be inspired to plan for EMR down time.

Reasons Your EMR Could Go Down:
Power Outage – Very few EMRs are setup to be able to handle a power outage. Sure, maybe you have a UPS attached to your server and some battery life in your laptop, but that’s only going to last so long. Plus, I bet your router/network switch isn’t on a UPS. What about your printer? You get the idea. EMR and power are friends.

Hard Drive Failure – At some point I asked someone why it was so common for hard drives to crash. They then described that hard drives are moving parts and anytime something is moving, there’s a higher chance that something will go wrong. Of course, now they have solid state hard drives that you can get. Either way, I’ve seen a lot of hard drives fail in my time. Of course, if you have a nice RAID setup for your hard drives, then you often won’t notice. Until they have to replace the failed hard drive with a new one. This could be the hard drive of your server or your computer. Most computers don’t have a RAID configuration.

Power Supply Failure – Most servers have redundant power supply. Why? Because they’ve been known to fail. If your server doesn’t have a redundant power supply, then be ready for down time. Most desktops don’t have redundant power supply and so they could easily fail too.

Network Cable – I don’t think I’ve ever seen a network cable go bad. However, I’ve certainly seen plenty of cables to servers bumped, moved, ripped out of the server. Everyone wonders why the server went down. Takes far too long to see that the network cable just got pulled out a little too much.

Switch/Router – Switches and Routers are what’s used in most offices to connect all your computers to the internet. Certainly these can go down if the power goes out. However, they can have other issues too. It’s not that common, but can sometimes cause down time for your office. Of course, wirelesss routers in particular can cause clinics lots of headaches when they go down.

Motherboard Failure – Might as well cover another common hardware failure: the motherboard. No motherboard and you can’t use your EMR.

EHR Software Issue – I’ve seen where a poorly tested and implemented EMR system would slowly use up all the memory on a server. Once it used up all the memory on the server, the EMR would take forever to do the simplest task. While not technically down since the server is up, it’s still a form of down time since users start refusing to use it in this state.

Internet Outage – This is particularly applicable to a SaaS EHR. Unless you have spent a lot of money to get redundant internet lines to your office (which in some locations is impossible), your internet will go down sooner or later. I don’t know how many times I’ve heard of some construction guy digging up the internet lines and causing outages for doctors offices. Happens all the time.

Much of the above can be applied to servers, desktops or laptops. Sometimes it causes a partial outage (ie. one laptop dies). Other times it takes down your whole EMR system (server dies). Either way, you should consider all these possibilities. Then, you see how you can minimize them (likely with the help of your IT support). Then, you think about what you’re going to do when the EMR down time happens.

Speaking from first hand experience, having a plan for EMR down time made all the difference when the event occurred.

Cost of EHR Down Time

Posted on July 19, 2011 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.

Mark Anderson has an interesting article on Sys-con media about the cost of EHR down time. Among other analysis he makes the following assertion:
“One hour of software downtime can cost a practice almost $488.00 per physician”

EHR down time is something that I don’t think most doctors put much thought into when they are selecting an EHR. I think that putting a dollar sign next to it will help many doctors to really consider the impact of EHR down time on their clinic.

I believe it’s incredibly valuable for a clinic to seriously consider the impact of EHR down time will have on their clinic. I worked at one clinic where, while it was rather annoying, the patient care wasn’t terribly impacted by down time. They had to ask a few more questions, but in almost every case they could provide the patient care that was needed whether they had access to the EHR or not. Although, they did still have the cost of entering the data after the fact once the EHR came back. Thankfully, they never had more than a couple minutes down time at any point in the 5 years I worked with them.

The challenge of EHR down time is also greatly impacted by your choice of EHR. If you choose an in house EHR software, you’re down time planning will be very different than if you’re talking about a SaaS EHR. In fact, I think this topic is so important that I’m going to save it for a future post.

I’d be interested to hear if other people have tried to put a number on the cost of EHR down time. Did you get something similar to the $488/physician/hour that Mark Anderson suggests? If you have an EHR, how much down time have you experienced with your EHR? What were the causes of your EHR down time?

Information Week Cover Story on Selecting an EHR

Posted on February 3, 2011 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.

Today I came across a link to this cover story for Information Week about selecting the right EHR. Unfortunately, the site requires registration to access the article, but you can also get a login for the site without registering on this great website called BugMeNot. Now to the content of the article.

The article starts off properly in describing that selecting the right EHR is a tough and challenging task. The biggest challenge is of course the 300+ EMR and EHR vendors out there. Sadly the advice they give in the article doesn’t do much to actually help individuals that are trying to select an EHR. Here’s the list of steps they offer (and my commentary):
The state of your infrastructure – No doubt this is an important part of an EHR implementation, but why they list it as a first step is a bit beyond me. The fact is that you really can’t properly assess the state of your infrastructure until you know which EMR software you want to use. Do you need a server room? Do you need a faster internet connection (ie. SaaS EHR)? Do you need tablets, ipads, desktops, etc? These answers aren’t known until you know which EHR vendor you select. So, this is an important step, but it’s done mostly during implementation instead of selection.

Features, functions and usability – The problem with this item is the order. Most doctors who are selecting an EHR don’t really know what features and functions are available in an EHR system. Sure, they have some idea of some of the features, but it is amazing how many new features they come across once they start demoing EHR systems. Remember, they’ve been focusing on patient care and not the latest EHR features and functions.

The other challenge for this area is that at a base level (which the article above mentions as well), the features and functions of most EHR software is pretty close. It is the more nuanced functions that differentiate one EHR software from another. So, this isn’t a first step in the EHR selection process. It’s a later step after doing the EHR demos. Instead of starting with features and functions, doctors should focus on the benefits they want to receive from an EMR as I describe in my EMR selection e-Book. These benefits will help to provide a guide for narrowing down your EMR options.

As far as usability, this is incredibly important. Just this is assessed at demo time as well. Although, I find this even better assessed when you either 1. do a test run of the software yourself and/or 2. talk to existing users of that software. That’s how you evaluate an EHR’s usability.

Networking and interoperability capabilities – Certainly you want to make sure it interfaces with your existing systems. This is barely worth mentioning since this is top of mind for most people selecting an EHR.

Technology knowledge – Another important aspect of an EHR implementation. Although, this isn’t very important in the EHR selection stage. I’ve never known someone to switch which EMR software they like best because they think their staff isn’t technical enough for one software but would be fine with another software. Technical skill can be overcome through training. It shouldn’t influence which EMR software you select.

Partner systems – This is the same as the interoperability capabilities mentioned above.

Deployment options – Finally something that’s a real differentiator. Knowing the pros and cons of an in house EMR and a SaaS (hosted) EHR software is very valuable and a great way to start narrowing down the field of possible EMR vendors.

Maintenance and support – Your ability to support the selected EMR matters and should be part of the selection process. Just most of the time this will really influence your decision to go with an EMR hosted on site or a SaaS based EMR mentioned above.

Now you can see why I wasn’t all that impressed with their list of EMR first steps. I won’t rehash my list of first steps. You can find them in my EMR selection e-Book. It’s free so go check it out.

The article does provide a list of best practices which is more valuable (with my commentary as usual):
1. Look for vendors that know your practice – Of course they won’t really KNOW your practice. However, there’s some real benefit in going with an EMR software that has 100 clients that are from your specialty. Don’t underestimate the value of them knowing your type of practice’s needs.

2. Evaluate the costs to acquire, deploy, maintain and support the hardware and software – Including all of the costs in your comparison of EHR vendors is really important. Don’t forget the hidden costs of training, interfaces, ongoing support, extra hardware, etc.

3. Consider a cloud-based or hosted EHR setup – Definitely worth considering. Just be aware of the benefits and challenges with going “to the cloud.”

4. Get the right training for your staff – Probably as important as getting the right training is choosing to make the time for that training. You can pay all you want for the right training, but if your doctor says he’s too busy to attend, then it won’t do much good.

This reminds me of a comment Dr. West made on a recent post:
“I know an orthopedic surgeon who bought an EMR for $25,000 but then didn’t have the time to waste in learning it, so they just use it for the scheduling calendar now. A $25,000 calendar!?”

5. Use a certified EHR – If you’re a new reader, you missed out on some of my amazing rants about certification. I’ll keep it short for this post. Basically, EHR certification provides no value to the doctor. The only exception is that it now is necessary if you want EHR incentive money. Other than that, it provides no assurance of anything of value to a doctor. Don’t focus on it. Don’t give yourself the false impression that it’s better because it’s certified. Evaluate the benefits of the various EMR software based on your needs and requirements.

6. Invest for the future – This isn’t meant to be interpreted “spend more money on an EHR system cause then you’ll be getting a better product.” In fact, the opposite case could be made that the more you spend on your EHR the more likely it’s a legacy system which is hard to upgrade and improve and won’t be great for your future needs.

The real message of this point is described pretty well in the article:
1. Assess the future viability (financial and directional) of the EHR company
2. Assess the scalability of the EHR software (do you plan to expand your practice? Can it support that?)
3. Will the EHR software be able to support meaningful use stage 2 and 3 (especially if you want to get the EHR incentive money)?
4. How much is the company investing in new features and releases? Will they be able to quickly adapt to your changing needs (ie. new interoperability requirements and needs)?

Conclusion
Obviously I think the article left a lot to be desired. It’s nice to see EMR selection as a cover story. I also think it’s hard in an article to try and cover everything that’s needed to be able to select an EMR properly. I also think it is really funny that for the article they sent out 20 RFP’s for a fictional company. Then, they compiled and analyzed information from the seven vendors that responded. Where are the other 13? Or maybe I should ask, where are the other 293 EHR vendors?