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Monday, January 18, 2010

January Newsletter: Buying the right EMR

In case you did not get the email version, here is the January newsletter in full. Hopefully, it will help you in avoiding some of the common pitfalls we've seen when people are choosing an EMR.

I'm the first one to admit I'm easily lured in by clever marketing and fancy labels when I'm shopping for food, shampoo, ... ok, everything! BUT, you have to know when to be more fastidious and read the labels. This is one of those times. Focus on whats most important and all the rest will fall into place.

- KH

BUYING THE RIGHT EMR

Several recent surveys (most notably by KLAS) have noted a drop in customer satisfaction with the EMR software purchased. While those surveys don’t offer opinions about why there is increasing dissatisfaction among EMR users, I have a theory. I believe that new buyers are not selecting the best system for their practices. Instead, they are being distracted from the most important criteria. Here are some points to consider when you are deciding what EMR to buy:

1. Buying an EMR is not like buying a car.
EMR software is still a work in progress. All the cars on the market today will get you where you’re going. All cars have pretty much the same set of controls. If you know how to drive a car, you can expect to be able to succeed in driving any car you buy. They do come with different features. They come in different colors. There are varying degrees of comfort and service, but no matter which one you choose, you will not find yourself with a car that you can’t drive or that will double your commuting time.

At some point in the future, perhaps the same may be true of EMRs. However, it’s not true now. Eventually, most EMRs will probably be well made. Today, the quality and focus of EMRs varies greatly. There is no standard for usability. There is no standard for applicability to your practice. There is no standard for even basic functionality.

2. CCHIT certification is not a standard for usability or applicability to your needs.
IO Practiceware supports CCHIT certification.
Along with pretty much all of our competitors, we expect to achieve CCHIT 2011 ARRA certification in early 2010. We believe that CCHIT certification is a good first step in developing standards for EMRs – and it’s required for the $44,000 per doctor incentive payments that you’ll receive beginning next year.
However, CCHIT certification does not address usability. An EMR can get CCHIT certified and be absolutely useless in your practice. It can be much worse than useless – lengthening your exam room encounters and jeopardizing your reimbursements.
The most important criteria when purchasing an EMR should be usability. Examine each EMR thinking about whether you can use it in your exam rooms. My advice is to look at nothing else – at least not until you’re satisfied that you’ve found the best EMR for you – in the exam room. Everything else is secondary.

3. Don’t even think about an EMR that does not have successful implementations in practices like your own.
After you think you’ve found the EMR that offers you the best chance of being able to use it in your exam room, then make sure that the company that makes it has at least some successful implementations in practices like yours. The more the better. I don’t mean to stifle innovation. New companies and new products can sometimes be much better than the more established incumbents. But, my advice is to let someone else be the first practice to use a new system. In fact, you really don’t want to be customer 1-20. Resist all offers to be a “Beta Site”. The risk is almost always too great.

4. Buy an ophthalmology specific EMR.
With one possible exception (NextGen) you’ve got to be nuts to buy an EMR that does not specialize in ophthalmology. It’s tough enough for ophthalmology specific EMRs to satisfy your needs. With a non-ophthalmology specific product, you’re lowering your odds for success to unacceptable levels. Just don’t do it. No matter why you think this might be a good idea, “Just Say No”.

5. Other considerations …… Price, Practice size, Longevity.
It’s reasonable to consider these criteria – but by far the most important criteria are usability and a successful track record. If you still have a choice after considering those, then you might take a look at these other, way less important, criteria.
Since the cost of all the successful EMRs is pretty much the same, it’s hard to use this criterion. There may be occasional bargains to be had, but remember that the most important cost is your time in implementing your new EMR. Buying an inferior system because it’s a few thousand (or even a few tens of thousands) of dollars less is really the dumbest thing you can do. If your new EMR costs you a minute more for each exam, you’ll soon find that the bargain price was no bargain at all.
To consider matching your practice’s size to your vendor’s size is not as dumb as buying the wrong EMR because it’s cheaper. Smaller vendors may have difficulty meeting the needs of larger customers. Larger vendors might not “care” about their smaller customers. However, this should be your least important factor in the decision making process. Buy the EMR that works in your exam room. All successful EMR companies will grow much larger in the next few years.

To that point, worrying about your vendor going out of business is not completely illogical, but it is for the most part irrelevant if you’ve paid attention to the other criteria mentioned above. If you buy the best EMR you can find, that company will prosper and be one of the survivors.

In summary, just in case you’re still wondering what I think is the most important criteria for choosing an EMR for your practice …… Buy the EMR you believe works best in your exam rooms. Don’t get hung up on any other issues. All other issues are way less important in the end.

All of us at IO Practiceware wish you and yours a prosperous and happy New Year.

Regards,

Gregory Leopold
CEO IO Practiceware

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