Coping With The Loss Of Your Ambulatory EMR

Posted on December 13, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Despite the struggles involved, most practices seem to have settled in with an EMR they can at least tolerate. Their workflows are, well, working, the practice management features seem to connect with the clinical ones and most clinicians are complaining about using it.

Yes, your practice may have had to go through a few systems before you found one everyone liked, wasn’t too expensive and had decent technical support to offer.  By this time, though you may have been a little scarred by the experience, hopefully practice leaders have gotten comfortable with the central role the EMR plays in the practice.

Then, you decide it makes sense to sell your practice to the local health system. It could be because it’s an irresistible deal financially, or you feel you can’t survive without their help and partnership, or any number of additional reasons. Everything looks good, but then you take a hit: your new “partner” wants to dump the EMR you worked so hard to find and customize. They want you to work on the same enterprise system they do.

Now, from a hospital’s perspective that may make sense. Here’s how one consulting firm lays things out:

“[When acquiring a medical practice] one critical issue is how to transition the workflow of these physicians and their staff from the practice-owned ambulatory EMR to the centralized hospital-owned EMR to ensure the efficient and safe delivery of care to patients,” it tells its hospital customers. In other words, it’s a question of when and how, not IF the hospital should require acquired practices to make the switch.

The thing is, while the hospital may have a comparatively large staff dedicated to integrating and managing the data pulled in from your ambulatory EMR, the reverse is probably not true. Unless your practice is particularly large, it probably only includes 5 to 10 doctors. In such practices, having even a single data expert on staff would be unusual. (Not to mention that hiring one part-time or as a consultant wouldn’t be cheap.)

In other words, for a while you may be fishing for your patients’ data as you transition to the larger team to which you will belong. Also, until the hospital health system completes integrating the data from your practice into its enterprise system, you may or may not have access to quality metrics important to running a practice these days, and the effect on your billing practices could turn out to be a disaster too.

At this point, I’m supposed to stop and tell you that all this can be handled efficiently if you take one step or the other. Unfortunately, I’m not sure there is any great happy ending to suggest at this point. If you have to give up your own ambulatory EMR, it’s probably going to be painful.

However, it doesn’t hurt to be prepared. There probably are some strategies, perhaps unique to your practice, that can blunt the impact of some of these problems if you’re prepared. That said, the move to a new EMR is always painful, even if the change ends up being a good one.