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All Things HIT

Feb 28 2013   11:38AM GMT

Year of the EHR switch? Easier said than done!

Posted by: AllinHIT
Black Book Ranking, Cerner, EHR systems, EHR User Satisfaction Survey, EHR vendors, Epic, McKesson, Siemens, Uncategorized

Last week, the results from Black Book Rankings annual poll were released.

The most interesting headline from the poll, based on what everyone else is reporting, is that 17% of the 17,000 active, polled EHR users are dissatisfied with their EHR and plan to replace it this year.  Hence, I’ve seen headlines such as, “2013, the year of the EHR switch” and “EHR users unhappy, many switching.” Despite this statistic, I offer my own associated headline: “Not so fast.”  Here are my thoughts on this stat and others revealed in the poll.

To begin, switching EHRs is easier said than done.  Although the desire is there, the cost of switching when all the numbers are crunched can be an impediment to change.  Of course, there are the hard costs, but the soft cost for training, mapping desired workflows (which I recommend is done before the selection process), lost productivity, and implementation costs like consultant fees for the build and go-live can easily tip the scale in the other direction.

Secondly, if the practice has to attest to MU for stage 1 and that vendor is ATCB certified for stage 2, then the Eligible Provider, and especially an Eligible Hospital, may elect to complete the MU stages before switching.

And finally, if the existing EHR has been implemented recently (within the last two years of go-live), then “EHR fatigue” could be a factor for delaying the change.  Physicians, nurses, IT and other stakeholders just might “make do” until its absolutely necessary, which could be determined by unmet quality goals.

The poll featured many interesting stats associated with switching EHRs as well. For example, 82% of those considering switching plan on going to an ASP/SaaS solution.  This would have been unheard of three years ago, with security being the major concern.  I also remember the huge discussion we used to have concerning the question, “Who owns the data – the EHR vendor or the practice?” Clearly, these concerns are a thing of the past.

More revelations from the poll include the top two reasons practices want to change EHRs. First  is the vendor not meeting needs, like accommodating workflows.

Second, many practices did not assess their needs correctly before choosing the original EHR. This is something I’ve written about many times. It’s a result of not mapping out those workflows in every area of practice prior to the selection process. And I have to defend some vendors when it comes to this issue. Although their compliance to meet the various MU stages has taken up development dollars and resources, not being compliant would be more devastating to profits and sales than developing other user needs not associated with MU.  I know there are the Epics, Cerners, McKessons, and Siemens of the world that have the resources to do both.  However, their resources are not the norm across the vendor spectrum.  Wow…I think I just discovered a selling point for the fore-mentioned vendors, coming just in time for HIMSS!

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