COMMENTARY

The Right EHR for an Oncology Practice

Neil Chesanow

Disclosures

April 15, 2011

In This Article

Introduction

Choosing an electronic health record (EHR) isn't for the faint of heart, between the cost, complexity, template customization, workflow customization, learning curves, downtime, glitches, tweaks, updates, interface designs, and training.

And that's if everything goes smoothly.

"It's a monumental project," Cindy Chavez, Vice President of iKnowMed, an EHR vendor in The Woodlands, Texas, is the first to admit.

Industry experts estimate that up to one third of EHRs are abandoned within 1 year after implementation due to profound user dissatisfaction. That's after paying what Eric Fishman, MD, an orthopaedic surgeon and EHR consultant in Palm Beach Gardens, Florida, estimates is $50,000-$100,000 per doctor for the EHR.

To ensure that you have a better outcome, here are 4 keys to success:

1. Pick an Oncology-Specific EHR

Broadly speaking, there are 2 types of EHRs: There are generic EHRs with specialty-specific modules -- such as oncology -- that may be purchased separately and are then integrated by the vendor into the core system (which is the same regardless of specialty). Also available are oncology-specific EHRs, often designed from the ground up by oncologists for oncologists.

Some oncology practices already use generic EHRs that have been customized for their needs, so purchasing an oncology-specific module may be economically appealing.

But experts point out that oncology is among the most complex and data-intensive of medical specialties. Generic EHRs designed for primary care practices may not offer oncology-specific modules with a full complement of features (eg, tumor staging, data-intensive workflows, chemotherapy dosing and administration, toxicity assessment and management, clinical trial and protocol management, drug inventory management, and survivorship care among them), features that are integral to the work that oncologists do.

"If we were talking about any other specialty, I might advise a practice to save its money and buy a generic EHR," Fishman says. "But if I were a patient going to see an oncologist, I would want that doctor to use an oncology-specific EHR. The additional value in care quality and patient safety is sufficient in oncology-specific products to warrant their use."

An oncology-specific EHR may be more expensive than a generic EHR, but Fishman cautions against being pennywise and pound foolish. A robust system from a reputable vendor that offers good training and timely technical support is worth the price, he says.

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