When I was last in DC at the Healthcare Forum, I heard hospital CIO Bill Rieger “Step Out” and talk about some of the challenges he faces as a hospital CIO. One of the things he said in his talk really rang true to me and is going to become an increasingly important topic in healthcare.
His comment: The ROI from Paper to EMR is Much Easier to Justify than EMR to EMR
This is a powerful and challenging thing to consider. I’m sure those at Epic, Cerner, Meditech, etc are licking their chops knowing that it will take a hospital CIO with special leadership skills to overcome this challenge. Yes, from their perspective they have some incredible customer lock in. However, Bill went on to describe that it’s not impossible to lead such an effort. In fact, his hospital was switching EMR software shortly after I heard him speak.
The biggest challenge with this idea isn’t that there’s no ROI to switch from one EMR to another EMR. There can be a significant ROI, but most hospital CIOs are afraid to make such a call. They’re afraid to really dig in deeply to find out what a new EMR might mean for their hospitals. Sometimes this is because they were the one who implemented the first EMR. Other times it’s they’re too risk averse to take on such a challenging project. It’s often easier to sweep thing under the rug than it is to pull up the rug and really see what’s going on under the covers.
I’m of course not suggesting that switching EMR software is always the right decision either. One of the first lessons I learned out of college was that change doesn’t always mean better. In fact, a change can make things worse.
I do believe that continuous improvement leads to beautiful results. Too many in healthcare IT are satisfied with status quo. If we’re going to continuously improve, one area we can start is to dig deeply into the ROI of going from electronic to electronic.
Indeed John, “Status Quo” will not lead to the electronic record or patient care we envision. Whether due to risk aversion as you indicate or significant vendor fees, many who do switch EMR’s avoid true conversion by starting over with a new EMR system and sunset the original system. This re-building of medical record content over time is not the ideal electronic record most patients have in mind.
A paradigm shift in thinking fixes the provider as holder of the consolidated electronic patient record versus reliance on the EMR vendor. Interfacing EMR, PACS, and other systems to a VNA (Vendor Neutral Archive), such as provided by HealthPort, ensures interoperability and control for the long-term.
Sean,
I’ve wondered if EHR’s will go the direction of vendor neutral archive at some point. I guess in some ways a Private HIE is similar to a vendor neutral archive, but there’s so much vitriol in the term HIE.