Money and Effort Will Kick In
Switching to another product requires a different effort, including cost issues. It is also extremely difficult to take information from one EHR and move it to another environment. Different systems have very different structures. Some are textual, with long text fragments that make up the medical record. Some of them have small labeled fields. If you are a cardiologist and you are taking the patient's medical history, in some systems you will be checking off boxes, whereas in other systems you will be dictating notes through Dragon or a similar product, using voice recognition. Those are very different products, and to move from one to the other and back again is very challenging.
The features of some systems are very different. For example, consider a scanned image. If you scan in an ER report from the hospital or a patient's previous medical record, some EHRs track whether the doctor looked at this document. Some EHRs don't track this. When you are trying to convert from one to another, how are you going to bring that information over correctly, and where are you going to enter it? There are many examples of trying to map out where information should be entered.
Sometimes an EHR fails because the vendor is failing, and that means that the product isn't working for you anymore. You might have lots of workarounds. In some cases, you end up with many pieces of paper that you are using to document and the system is scanning them in. Sometimes the vendor is abandoning the product and moving to a different product and therefore has stopped maintaining and fixing your system. They are no longer investing their money in it. We have vendors who have said, "We sold a product that we put in your office, and now we want to sell you a service out of the Cloud." They make it impossible for you to continue to use that product in your office. These are things that can happen and you are subject to them.
Another situation that I have seen is when the EHR is no longer being actively sold. The manufacturer says, "No new practices are implementing this system." That is a very serious problem strategically. Therefore, practices need to keep an eye on what's going on with the product. Is it moving forward? Are there signs that this product is no longer a viable option to maintain your records?
Remember that the punchline to all of this is that it's the practice that is responsible for maintaining patients' records, not the EHR vendor, and HIPAA security is the responsibility of the practice, not the vendor.
Medscape Business of Medicine © 2013 WebMD, LLC
Cite this: Unhappy With Your EHR? Here's How to Improve the Situation - Medscape - Jan 17, 2013.