Upgrade or switch your EHR? - The question you will eventually have to answer
The latest research regarding EHR adoption, EHR satisfaction, and the EHR market shows that due to satisfaction issues among consumers and the demands exerted by the Centers for Medicaid Services (CMS) Meaningful Use (MU) program the EHR market has experienced “provider flight,” whereby those who can afford to, have switched EHR systems or have plans to in the near future. Although this is not to say that the vast majority of users are dissatisfied with their systems current functioning or its ability to cope with the demands imposed by the MU program.
Evidence provided by a Medscape survey shows roughly 33% of physicians surveyed were dissatisfied with some aspect of their EHR. However, 84% of participating physicians say that they plan to keep their EHRs. This data reveals that the “upgraders” will likely occupy a larger section of the market than the “switchers.” In light of pressures from the MU program, dissatisfaction with current EHR performance, or both, at some, the decision to switch or upgrade may be up for debate in your practice.
The decision to switch or upgrade is best viewed as a balancing of cost and benefits. On one hand, one must consider whether a complete switch of an EHR system will result in benefits that outweigh the sunk costs of making the switch. When considering an upgrade one must think in terms of sunk costs again and whether the upgrade will rectify any of the current problems in the EHR system or simply just paper over a more serious need such as attesting to MU or remedying serious inefficiencies. If the problems are deeply ingrained, you must ask whether the upgrade can eliminate enough of the current problems with the EHR system to justify avoiding a full on switch.
The following list offers a few considerations that should be considered when weighing up these choices.
1) Direct Costs: These include software, subscription fees and any extra human resource costs directly stemming from replacing or upgrading software. The question to ask is; how much will the direct costs of a full switch compare to that of an upgrade?
2) Productivity Costs: Lost productivity due to a switch or upgrade results in staff being diverted from normal duties to adapt to software changes, also the amount of time needed to become fluent in the new software. Ask yourself, will an upgrade take up less time as they adjust to changes or would a whole new system be just as demanding?
3) ROI: When considering ROI in light of the decision to switch or upgrade think of the cost of adopting a new system or upgrading with potential lost productivity costs relating to either option. Ultimately, the long-term return on investment must be contrasted with the comparative benefits of upgrading or switching.
The decision to switch or upgrade your EHR system is not something that can be solved with an easy calculation, however, it is likely a decision most practices will have to make at some point. The decision is best viewed in light of long-term goals, as both should ultimately be the same (improved billing, coding etc.), and whether your practice can justify the ROI from either decision.
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