EHR: The Good, the Bad, and the Ugly—Real Life Stories

EHR: The Good, the Bad, and the UglyIn 14 years of business, we’ve heard thousands of EHR stories from physicians, administrators, and other medical staff. We’ve noticed a few clear trends as the stories fall into 3 distinct categories. Let’s call them the Good, the Bad, and the Ugly:

The Good

“With [ABC] EHR, I navigate my patients’ clinical data faster and more efficiently, and I don’t have to wade through other physicians’ notes to get to my own notes. It’s quicker to electronically prescribe than to write out a paper prescription, and it bypasses the sloppy handwriting problem that can lead to errors. This results in better patient care and can lead to sharply reduced malpractice risk. In addition, our response time to patient inquiries has improved greatly, which is something our patients have gladly noted.”

“One of the best things I love about our EHR is that I can check the charts from home. Sometimes patients make appointments before they are instructed to, which doesn’t allow me to maximize my time in the office. I also spend less time in the office doing research and can easily accomplish my research goals from the comfort of my home.”

“Because of the efficiency gains [QRS] EHR brings to our practice, the staff now spends more time reviewing patient charts for quality and completeness, which has directly enhanced the level of patient care. Patient satisfaction levels have notably increased, as has the physicians’ confidence in the comprehensiveness and quality of the clinical data.”

“Our EHR is the primary tool at the foundation of our practice—the tool that the physicians and staff count on to be reliable, provide accurate clinical data, and build and secure the integrations necessary for the current and future digital age.”

Trend: The good EHRs deliver substantial practice workflow enhancement and productivity improvement, while simultaneously creating an organized and less stressful work environment for the physicians and staff. The good EHRs support an enhanced level of patient care and help create an improved patient experience.

The Fix: If you fall into this category, consider yourself a success story—sit back and marvel at your practice’s new-found efficiency and focus your attention on the patients and growing your practice now that inefficiency and stress are no longer a part of your day.

The Bad

“[XYZ] EHR is quite complicated, and we ended up having to hire a full time, in-house IT employee. We rolled out the EHR to physicians from April to June. The doctors who went live in April and are really good with the system are still 25% down in productivity. This has slowly been improving, but the doctors have quite a lot—about 2 hours—of ‘after work’ to catch up at the end of the day. We had to set up VPN connections between the office and every doctor’s home so they could finish their work at home.”

“It took our practice four years to narrow down and select an EHR vendor. We went live 6 weeks ago and our physicians say they are doing more work now than they were before. One of our physicians says he has to cut patients out of his schedule on a daily basis. In addition, he used to go to the hospital at 6:45 AM and get home at 6:15 PM. After implementing the EHR, now he leaves the office at 7:00 PM and his wife and kids are upset with him for the lost time. He is also upset that he has to do more work, manually entering in patient data, which is not why he became a doctor. He became a doctor to take care of patients, not to type and treat fewer patients. The only good thing he could see from it is being able to access patient charts from home, and then perhaps a light at the end of the tunnel for better patient care sometime in the future (keyword = sometime). The check-out staff member said, ‘They trained us in two days and then left us for the wolves.’ It was real bad, patients were very upset.”

Trend: The bad EHR stories always involve practice-wide workflow disruption, unexpected increases in expenses, decreased quality of life, and/or decreased patient satisfaction.

The Fix: Call your EHR vendor and request their Professional Services Group to come in and evaluate your practice’s workflow. Whether your staff needs more training or more face-time with super-users, your EHR vendor should take care of you. (After all, they want you to succeed using their EHR, right?)

The Ugly

“We are a 200+ physician group that signed with an EHR vendor 3 years ago. Satellite offices that have already gone live on the EHR system are still using paper charts and writing prescriptions by hand. Our central office planned to fully implement this fall, but we have suspended that indefinitely since the other offices that are already live on the EHR had patients lined up out the door due to slowness and difficulties using the EHR.”

“After trying to use the EMR and failing, we SHUT IT OFF! We have 7 doctors—our head doctor made numerous calls to the higher-ups at the EHR vendor to try to get the program to work. Nothing worked and he’s 100% convinced that they just don’t understand our specialty.”

Trend: The ugly EHR stories always involve failed EHR implementations, extreme productivity losses, physician and staff frustration, and wasted revenue.

The Fix: Go over your contract to see if you have a “failed implementation” clause. Many EHR vendors guarantee success or are willing to work with your practice towards EHR implementation success. However, in some cases, the EHR vendor can’t fix the problem because the software just doesn’t match your practice workflow or their support/implementation teams are inexperienced. Sadly, if this is the case, it might be time for you to break up with your EHR vendor.

But all is not lost, many EHR vendors offer transfer pricing from one software to another. You’ve learned from past mistakes and the next time you’ll know what your practice requires to achieve success and the questions to ask to make sure the vendor will deliver it.

Don’t feel stuck—you too can have a happy ending:

“After suffering through three failed attempts to implement traditional EMRs, we were thrilled to find a solution that was fully embraced throughout our entire enterprise. This EHR vendor clearly understands our complex clinical workflows, and their robust EHR easily conformed to the diverse requirements of each of our providers. We could not have found a better partner.”

Related posts:

  1. EMR: Don’t Settle for Less
  2. EHR: Experience from the Field
  3. Finding the Best EHR for Your Medical Practice: 10 Key Questions to Ask EHR Vendors
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