How Not to Buy an EMR

February 12, 2009

I’m sure you know by now that buying an EMR is a huge investment - not only financially, but in terms of time and practice resources.

I’m sure you know by now that buying an EMR is a huge investment - not only financially, but in terms of time and practice resources. Like any big purchase, careful research and staff preparation are the keys to avoiding “buyer’s remorse.” Unfortunately, you can’t turn to Consumer Reports for a rating of EMR products. You’re pretty much left to your own devices to sleuth out the good and bad points for each product.

Additionally, the din of advisors and EMR sales reps can confuse a physician on what he really wants and needs, and what he is being tempted to buy. This can only raise the risk of getting stuck with a product that does not match the practice’s needs. Here are some pitfalls to avoid:

Caving into peer pressure. Don’t implement an EMR just because it seems like the thing to do. This may sound like something your mother would say, but in truth, the hype about EMRs is sure to make some paper-based practices feel like they are falling behind. There are a number of reasons why this isn’t true:

  • EMR implementation is a hard job and those going through the process are sure to wonder if they made a mistake. The final outcome can be good, but only if your staff is dedicated enough to go through the entire process with a can-do attitude.

  • You must have a goal in mind. An EMR is really just a tool. And like any effective tool, you must know what task you are trying to accomplish, or the tool will be of no use. Buying an EMR system just so you can “store patient records on a computer” will result in a lot of frustration among your staff, not to mention a big waste of money. Some reasonable goals to set:

  • Cut out transcription

  • Eliminate lost charts

  • Make prescribing easier

  • Improve patient care/P4P measures

  • Allow access to records from home/hospital

  • Improve coding to drive higher reimbursements

Forcing the change.

One of the biggest mistakes administrators can make is to force EMR implementation when there is significant resistance from physicians and staff. Office managers often understand the potential value before clinical personnel, so they try to push the idea. But they forget that implementing a new EMR will change the lives of their physicians far more than it will for their administrative staff.

As the core business of your practice is to care for patients, a forced EMR implementation can be extremely disruptive to patient care, especially in the beginning. If those who are “in the trenches” don’t want to implement, they can easily sabotage the process by not cooperating. To prevent this, first find out what would make your physicians’ lives easier, not harder. Then pitch the EMR as a tool that will help with these exact issues. Use specific examples to make it real for these unconvinced users.

Oversimplifying the endeavor. Sales reps can make an EMR purchase and implementation seem simple. It is not. A quick-and-dirty implementation may be easy, but to make fundamental changes to your practice’s work flow and operations takes a lot of work and planning. Don’t get me wrong - I would never practice without an EMR - but be prepared to chart out a carefully planned transition.

Robert Lamberts, MD,who is board-certified in internal medicine and pediatrics, practices in Augusta, Ga. His practice won the 2003 Davies Award for outstanding application of IT in a primary-care setting, and he has lectured extensively on EMR. He also writes the popular medical blog "Musings of a Distractible Mind" (distractible.org). Dr. Lamberts can be reached at rob.lamberts@gmail.com.