THE DIGITAL PRACTICE

Redesign or replace your EMR system?

With total MU almost here, the question must be asked.

By Peter J. Polack, MD, FACS

Our practice implemented EMR in 2008. Due to proper planning and excellent advice, our transition was fairly painless and we had minimal loss of productivity moving from paper to electronic charts. Over the years we have added and customized numerous templates to make our workflow continuously more efficient.

These steps — proper planning, smooth transition, maintenance of productivity and efficiency enhancement — were important. Ours is a large practice, with about 150 employees.

LOST IN TRANSLATION

Recently, our EMR vendor presented us with a major upgrade to comply with Meaningful Use (MU) provisions. Unfortunately, much of the custom work we have done since 2008 might not transfer to the new knowledge base. And our practice could contend with a significant productivity decrease if we upgrade.

The new version has workflows designed in a developer’s environment, not in the ‘trenches’ of a multispecialty practice like our version. In the new system it takes three or four mouse clicks to handle a one mouse-click function in our existing version. Our busier doctors see 60 to 70 patients a day; this would be a nonstarter. So, should we upgrade and pay the productivity price or look at a new EMR system?

If you are facing a similar dilemma, consider your options before you make the potentially expensive and painful decision to replace your EMR system.

ASK THE RIGHT QUESTIONS

I spoke with Chris Johnson, CEO of Untangled Solutions, a Healthcare IT firm experienced in EMR implementations and replacements. He said practices should ask themselves the right questions.

1. Why do I want to leave my current product?

2. If I go with a new vendor, does my current infrastructure support the move?

3. How quickly does the new vendor respond to or answer questions? (Ask for references and discuss this issue with the vendor.)

4. Does the new product have a visible roadmap to future releases that offer valuable features to my practice?

5. What is the new product’s history and how has it certified for MU in the past? How does its future look?

NEW STRESS RELIEF

In general, the bigger the EMR vendor, the more likely it can provide support and have the capital to maintain its certifications, although size is never a guarantee. It’s also important to check the vendor’s market share for your particular specialty.

We are still deciding on whether to redesign or replace, but we also are working with the vendor in hopes it will adopt some of our ‘best practices’ regarding templates and workflow. What is proven to work in our busy practice — the stereotypical customer — is likely to work in others.

In the future, practices are likely to replace their EMR system, so it’s useful to run through this exercise occasionally — particularly as backup for those moments when you feel like taking a sledgehammer to your office computer. OM

Peter J. Polack, MD, FACS, is co-managing partner for Ocala Eye, a multi-subspecialty ophthalmology practice located in Ocala, Fla. He is also founder of Emedikon, an online practice resource for physicians and administrators. His e-mail is ppolack@ocalaeye.com