EHR replacement: motivations to make the switch

Signs that your practices needs to switch EHR system may not be immediately evident. For many practices the initial motivation for EHR replacement comes in one of the following forms:

• Clinician frustration, loss in productivity
• Poor timeliness of reimbursements
• Poor communication with patients, including missed appointments
• Missing documentation requirements as needed by insurance providers / the need for continual addendums to notes
• Poor work / life balance for clinicians (documenting at home or over lunch hour continually)

As you can see, many of these motivations have an indirect relationship with the EHR system itself, which creates a divide between practice process issues and system issues. It is therefore important to assess your current practice to understand the true motivations behind a switch in EHR systems. In order to accomplish this, you must analyze questions such as:

• Are we providing the best care to our patients?
• Are patient visits spent focusing on patient care (not focusing on documentation)?
• Are the clinicians efficiently managing their time?
• Are we personally connecting to our patients as best we can be?
• Do we meet all current documentation requirements and get paid in a timely fashion?

If you answer “No” to many of these questions, it may be time to consider changing your EHR system. Next, you must envision what your ideal practice would look like and set goals for your practice. This will provide a roadmap for your EHR search process.

Immature products & clinician dissatisfaction

A 2013 report by Black Book Rankings found that as many of 17% of medical practices would be switching out their first EHR within year end. The survey polled 17,000 active EHR users. Respondents reported numerous cases of EHR systems underperforming badly enough to lose revenue. Most notable issues include lack of integration with other programs, networking issues, and limited mobile EHR use.

Recommended reading: EHR selection survival guide - 7 steps to selection success

EHR meaningful use directives are meant to improve the quality and coordination of healthcare in order to improve documentation processes, streamline healthcare information, and move toward better public health. It was hoped that compliance to meaningful use would result in increased transparency and efficiency in healthcare documentation, with better clinical outcomes and informed patients. Unfortunately, meaningful use (and the associated incentive payments) created a market for immature products and generalized systems that have failed to meet the needs of specialists. The Black Book Rankings survey found that 31% of respondents indicated that they were dissatisfied enough to consider switching systems. The most common reason provided was that the system did not meet the specific needs of the practice. The most important word to remember in replacing your EHR system; specificity.

When considering replacing EHR systems, you must identify the motivations behind the decision. The clinicians may support the change in hopes of increased usability and increased efficiency with documentation (which is typically the least favorite part of a clinician’s job). The administration team may support EHR replacement in hopes of higher revenue and increased patient visits. However, vendors will also be motivated to help you replace your EHR system because they are looking for new business, so it is important to weed through the marketing propaganda and thoroughly analyze whether the system meets all of your specific clinic requirements when you approach your selection phase.