What you need to know before marrying an EHR

Today you can easily bump into articles that glorify some consumer oriented health app or device, but you can just as easy come across posts and fierce discussions criticizing enterprise health solutions. So as we daily consume this health 2.0 content it seems more like enterprise technology is a decade behind consumer technology, but the truth is there are many of both reliable and deficient products on the enterprise side as well as on the consumer side. Then why is it harder to stumble upon articles that criticize some of the inferior consumer health apps? The main reason is because you can easily drop the consumer apps without any significant expense and a product that does little to no damage may only get some 140 character rants. If the app doesn’t work as expected or it’s hard to use you’ll probably just delete it and you are on to the next one for free or just a few dollars.

While you can get off an app avoiding a battle, there will be a lot of blood sweat and tears, quite literally, if you make the wrong decision when choosing an EHR for your hospital or practice. The process of adopting EHR has proven to be exhausting for both hospital’s resources and the staff’s morale, and it can often affect the hospital’s future success. From hundreds of thousands and millions of dollars wasted, to disappointed patients and even CEOs resigning, poor decisions over EHR selection and implementation have caused a lot of pain for healthcare institutions.

Still, fueled by the incentive programs and other initiatives, EHR adoption in the US has increased significantly over the last few years, but ‘surprisingly’ the percentage of buyers who replace their existing EHR is also increasing, reaching 40% in Q1 2014 according to systems advisory group Softwareadvice.

ehr software replacement

Another report from KLAS has stated that almost 50% of large hospitals plan to change their EHR by 2016. Knowing that switching to a new EHR involves huge costs, some might be wondering why this trend is rising at such a great pace, well the answer is simple:

The majority of EHRs are slow, outdated and absolutely NOT user-friendly.

Some of the most widely deployed EHRs give you the experience of a 90’s system, they have an incredibly complex interface, include an unacceptable number of errors, they can’t integrate or communicate with other healthcare systems and with all these limitations they still cost a fortune to adopt.

Looking at how drastically enterprise systems in other areas have improved over the last 20 years in terms of connectivity and usability, healthcare providers know that their current systems are left behind and they are willing to sacrifice additional resources in order to replace their deficient solution with a better one that will actually help them improve efficiency and patient care.

73% of largest practices would not purchase their current EHR system again if given the choice, according to a 2014 survey by MPI Group/Medical Economics.


Adopting EHR is like getting married and replacing the existing system means going through a divorce first, and we all know how expensive and stressful divorces can get. To make sure you won’t make the wrong decision again we will mark some crucial qualities that you need to consider when searching for the right EHR partner.

Modern is more efficient

We all know more than a few physicians that have difficulties using their EHR or practice management system, but those same people are using a bunch of different social networking or health & fitness apps with no trouble at all.
Most EHRs are old-fashioned and provide a poor user experience, which makes it hard for physicians to digest data and it increases the possibility to miss important information which could affect the quality of care. Healthcare providers already have a really exhausting job, they don’t have the time to search the way out through the long mazes of information and features displayed on their screens. Wasting extra hours of physician time without adding any value to patient care is one of the main reasons why the healthcare system is broken.

The most common reason buyers replace their existing EHR, involves the current system being too cumbersome (too slow and complicated)


To avoid implementing a system which your clinicians will diagnose with R46.4 (ICD-10 slowness and poor responsiveness), you need to aim your attention towards the following marks when evaluating EHRs.

A simple intuitive interface, always highlighting critical information and features, is one of the key factors to ensure your future EHR success. This will help physicians conquer their new system more easily without having to spend weeks or even months on training. When you are reviewing this aspect of the EHR it is efficient to involve the not so tech-savvy physicians, they should start with completing some of the most common tasks like: finding an existing patient, creating a new patient, entering a diagnose, checking the medical history, making a referral, ordering prescriptions etc. You will be able to extract some valuable insights from both physician’s feedback and the time they needed to complete the specific tasks on the test version of the system.

switches ehr

Less is more, the system you are about to adopt shouldn’t be drowned in countless features that your hospital or practice wouldn’t use in its current state. Every organization is unique and even if some of the EHR’s features are essential for other healthcare providers they might only present a burden for your hospital. An EHR freed from irrelevant features will be accepted with less confrontation by the doctors and it will help in the progress of physicians’ productivity.

Another element that has proven to help in achieving a better workflow is the ability of the EHR to arrange more problems to be solved by the physicians and less by support. For example if an action can’t go through, the system should push notifications to the physician, describing the reason for the obstruction and how to move forward. The system should also engage in some situations, even when there is no action causing conflict, by requiring confirmation or re-entry to minimize physician’s errors.

These are just a few of the enchantments that you will be demanding once you have implemented the new system. That’s why it’s essential for you as a buyer to inquire about how the vendor handles optimization requests before making a purchasing decision.

Your network is your net worth

We’ve all heard this before and while we might agree or disagree on whether it is valid to evaluate a person by their ability to build a network, l strongly believe that it is legitimate to evaluate EHRs and other health IT solutions by their ability to connect with other systems.

Interoperability is still one of the most commonly mentioned words in discussions and articles regarding different healthcare systems, and in most cases it is used to criticize them rightfully.
Many of the present EHR systems are hindering collaboration and efficiency by not being able to integrate with other systems. Instead they are using duct tape solutions, forcing the physician to export information from one system and transfer it to another manually. This lack of connectivity and integration is a serious hindrance for physicians because it doesn’t allow them to seamlessly create, share and update data.

The need for integration between applications is one of top reasons for replacing existing EHRs, with more than 20% of buyers stating so in 2014.


It is of immense importance that the EHR you’re planning to adopt is based on technologies that allow the system to seamlessly communicate and integrate with solutions such as practice management, patient portals, and other relevant systems and devices present at your hospital. This will cause you a lot less headaches with billing, scheduling and countless simple tasks that might turn complex if integration is not something that attracts your medical software vendor.

Even if you are a small organization and don’t have many different systems and devices, choosing an EHR that is able to smoothly connect with other technologies will have an impact on your future success. With Health 2.0 moving fast we’re seeing a lot of different applications and devices acquire millions of users rapidly. So you wouldn’t want to spend additional resources and change your EHR again, because it wouldn’t be able to connect with the app that 90% of your patients will be using in a year or two from now.

Is cost still your worst enemy?

If you manage a small clinic or a rural hospital, you probably don’t have a tons of resources to spend on adopting an EHR, even if you have you might still hesitate to spend many of those resources in this direction mostly because of the widespread criticism about how EHRs haven’t been cost-effective.

Almost 50% of buyers stated that cost is one of the factors that influence their decision when switching an EHR. This concern comes of no surprise because EHR implementations have been costly

ehr adoption costs

With everyone aiming toward affordable care, excessive EHR prices only seem to be hindering it. However with the health IT market growing rapidly so has the number of companies providing these solutions, leaving healthcare providers more choices with a variety of pricing plans available.

The most crucial factor for a cost-effective adoption is choosing the cloud to host clinical applications and data. Cloud-based EHRs help you evade the huge investments in IT infrastructure and services, smooth the implementation process and give you a clearer picture of the total cost of ownership especially with the SaaS model. On the contrary, on-premise solutions make it hard for physicians to realize their full cost of adoption which involves acquiring servers and additional hardware, IT staff resources, maintenance and upgrades costs etc.

Having more IT responsibilities and higher expenditures is definitely not what healthcare providers are looking for, hence it’s not surprising that almost every healthcare organization is looking to embrace the cloud in the near future.

There are still a lot more issues that need to be addressed, and there are some that are being solved as you read this, the fact is there are more choices than ever now and with good research, planning and execution we will see more healthcare providers who are proud to affirm that their EHR investment was worth the effort and resources.

“When healthcare organizations use an EHR system to its full potential, it means less redundancy, fewer errors, reduced costs, and capitalization on the promise of a higher level of care” – Dr. Heather Haugen