Monday, March 17, 2008

Is Wal-Mart off the Wall(-Mart)? Thoughts on EMR Cost

Wal-Mart, beloved and reviled omnivendor, plans to sell "affordable" EMR software to smaller practices that are loath to invest in "higher costing" systems. Hardware, software, installation, maintenance and product training will be available through Sam's Club for a price that, apparently, undercuts competition by 50%.

Well, I don't know whether I should clap my hands together like a jolly newborn or claw at my own skin while listening to this song.

Because, on the one hand: Nothing could be a clearer harbinger of widespread EMR use and adoption than to see Wal-Mart jump on the proverbial EMR-bandwagon. And that's nice.

But, on the other hand: What?!?!?!

If practices reluctant to adopt EMR are willing to invest in systems simply because they're cheap, we suspect these practices are laboring under some major misconceptions about the value and function of EMR.

Thus, we would like to offer our two cents regarding EMR cost versus EMR value. (Since our specialty is ophthalmology, we will speak about our experiences in that particular field -- though we believe you can apply our points more broadly to other specialties.)

When considering the switch to EMR, a practice should calculate the value of the EMR system. We believe value can be assessed by the following three questions:

1. Will the EMR compromise workflow and slow me down? If an EMR slows you down in the exam room, you can't afford it - no matter what it costs. Unfortunately, many EMRs, particularly general purpose EMRs, do just this, and claim it to be a necessary drawback of all EMRs. This is not the case! Specialty-specific EMRs, like IO Practiceware, are generally better at addressing the needs of each practice - and so can actually enhance and improve workflow. We can't speak for all specialty-specific EMRs, but we know, for a fact, that ours is fast.

2. How much time will my staff and I have to spend customizing the software? Most vendors require that you create or modify templates. They claim that these templates are an important part of customizing process. We believe, however, that asking doctors to create templates for their most common findings is simply an admission that the EMR company (because it wasn't designed exclusively for a specialty, like ophthalmology) doesn't understand enough about that specialty to create software that allows physicians to enter their findings. While templates might seem like a plus, they actually ask you to make decisions about EMR that you are unequipped to make - not because you don't know your field, but because you are unequipped to design software. No offense, or anything. But, yeah -- I can't run a 3 minute mile, and you can't design software! Deal with your limitations!

3. How much help will I get transitioning over to EMR? Implementing an EMR is a big change for your practice. We have learned from experience that you can use some help during the first weeks after installation - particularly with respect to solving the inevitable workflow problems that arise as you move to any new system. If your EMR package doesn't come with this kind of customer service and attention, then it is likely you have invested in a product you won't be able to use properly.

Now that we've laid it down, it's time for us to toot our own horn: We believe that IO creates more value than its competitors because it's much faster in the exam room, it can be easily integrated and customized to suit your ophthalmology practice's workflow, and its package comes with training and support that ensures success.

We know that many of you fret about EMR cost. Many vendors, like Wal-Mart, charge “a la carte” – a certain number per physician, per office, for data conversion, equipment interfaces, training, on-site support, and other add-ons. But IO prefers inclusive pricing – including in the initial estimate all the things a particular practice will need. (For more info on our pricing, click here.) And while different vendors use different formulae to calculate price, the truth is: all the serious EMR players in ophthalmology end up with about the same result. And if not, well... just ask yourself the three aforementioned questions and determine the true value of your (ostensibly) "cheap" purchase.

IO Practiceware offers you a complete system. We sometimes joke that our competitors sell an EMR "kit." But we deliver a finished product - without sacrificing any potential for customization.

IO Practiceware is revenue positive from the start -- with no sunk costs, not even in the first year. This should be a major consideration in your quest to find an EMR that's right for you.

Questions? Comments? Leave us a note below or send us an email.

(Cited: FierceHealth IT's article on Wal-Mart's EMR Marketing.)


  1. But how much time will IO save me in the exam room? You're argument is persuasive, but my practice has heavy work flow. I can't afford delays and, frankly, I'm scared to switch over. Is this a rip the bandage off moment for me?

  2. Jenny,

    There is no denying that practices with heavy work flow -- indeed, all practices -- experience initial disruption when installing an EMR system. We'll be the first to say that transitioning to IO Practiceware is certainly not seamless. But what distinguishes our product from other ophthalmic EMRs is that speed was one of our top, if not our single-most important priority in designing the software. Believe it or not, you WILL save time in the exam room. Additionally, our on-site training and support provides your practice with the tools to make sure that the initial "rip of the bandage" lasts only for a very short time, and is dealt with with the care and attention necessary to not only restore your work flow, but to make it more efficient.

    Indeed, it's an important consideration, and we understand your trepidation. But to see how fast IO really is, you can schedule a demo here.