Best EMRs for Small Practices

Leslie R. Kane


May 21, 2009

In This Article


Choosing and using an electronic medical record (EMR) can be daunting for all medical practices, but small groups -- from 1 to 3 physicians -- have special challenges.

The unique hurdles for small practices include the following:

  • The cost of an EMR can be a greater percentage of income when fewer doctors are bringing in revenue.

  • The work slowdown and potential income loss when an EMR is implemented can be a more significant hit to a small group. Practices typically require from 3 to 6 months to get fully up to speed with an EMR.

  • Small practices rarely have an IT (information technology) expert on staff to maintain the system and troubleshoot if technical problems occur.

Nationwide estimates suggest that although about 24% of physician practices use EMRs, only 12% of physicians in practices with 5 or fewer doctors do so.

"A 1- to 3-doctor practice doesn't have the luxury of a physician who can work part-time while choosing and implementing the system," said Eric Fishman, MD, President and Chief Executive Office of, (, a free online service that provides EMR recommendations for physicians. Dr. Fishman elaborated: "When you're seeing half as many patients as usual because of work slowdown from implementation, that lack of productivity dwarfs the cost of licensing, scanner, or hardware."

Bruce Kleaveland, President of Kleaveland Consulting, a health information technology advisory firm in Seattle, Washington, adds: "The most important distinction between small and large practices is that small practices rarely have dedicated IT support. A large practice might have someone whose sole job is to manage software, maintain the equipment, software, updates, backup, and make fixes when necessary. A small practice may have the same needs as a large practice from a system capability, but will not have IT support resources available."

The following guidelines can help physicians in small practices choose the most appropriate EMR.


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