5 Reasons to Replace Your EHR: Challenges and Solutions

By: on October 19, 2016

If you’re thinking of dumping your electronic health records (EHR) system to buy a better one, you’re not alone. A Software Advice study of medical software buyers found the number of practices replacing EHR systems has increased since 2010:

Five-Year Retrospective: Buyers Replacing EHR Software

EHR implementations are rarely cheap or fast, so it’s significant that a growing group of physicians are willing to start over with a new system instead of trying to make their current one work.

In this article, we’ll help you figure out if it’s time for you join that group of replacement EHR buyers. Check out these five common reasons for getting rid of EHRs, followed by suggested solutions and advice on whether to stick with it or start shopping.

When EHR Challenges Become Deal-Breakers

EHRs can take months to learn and cost a pretty penny, so replacing your software is likely a last resort measure that you don’t want to take lightly.

In fact, a recent report from research firm Black Book would make even the most eager physician hesitate. Researchers surveyed hospital-employed EHR users about their experience transitioning to a replacement system and found:

  • 90 percent of nurses reported the EHR changes diminished their ability to deliver hands-on care with the same level of effectiveness.
  • 7 percent of respondents at the managerial level or higher claimed they or their peers were terminated directly due to EHR replacement cost or loss of productivity.

This shows EHR replacements can have unintended consequences for just about everyone on your team.

However, it’s important to keep in mind this study focused on hospitals, which have different needs and challenges than independent practices.

Independent practices are generally more agile than larger providers and therefore better able to choose and implement a system that all staff can grow to appreciate.

Plus, practices who switch may actually find they’re more profitable once the replacement system is deployed, thanks to increases in productivity.

The issue comes down to risk versus reward—how do you know if you should stick with an unsatisfactory EHR or risk getting a new one?

It all depends on how many issues you’re experiencing and how disruptive they are to your practice. No software is perfect, but there’s a difference between EHR challenges you can overcome and deal-breaking flaws that warrant a replacement.

We interviewed health IT expert and author Dr. Chuck Webster to get his take on the five challenges below. We also invited real physicians on the social network SERMO to weigh in with their thoughts.

Challenge 1: Your EHR Is Cumbersome Or Faulty

According to our buyer trends report, the most commonly cited reason medical practices replace their EHR is because their current system is “cumbersome or faulty.” One of the commenters on our SERMO page describes why that can be so frustrating:

If you’re regularly seeing error messages, dismissing nonsensical alerts or clicking through too many screens to get to the one you want, your EHR may be ripe for replacement. That said, don’t underestimate the power of customizable configurations and extra training.

Webster says some products allow users to change the workflow of data entry screens to improve ease of use.

For example, you can make the “past medical history” information appear earlier in patient encounter notes, if that’s one of the elements you’re constantly trying to find.

Webster suggests a litmus test you can perform to see if your system is capable of such customizations.

Consider sticking with the EHR if: You can customize the system’s workflows and alert notifications, then mine the vendor’s training materials for other tips to improve usability/productivity. Nowadays, many offer a wealth of materials, including online webinars, tutorial videos and on-site sessions with service reps.

Replace the EHR if: No amount of training resources have helped your team save time or personalize the system. It’s the software’s ineffective design—not the way you’re using it—that isn’t up to snuff.

Challenge 2: Functionality Is Missing

Some EHRs fail to meet your expectations from the start because features aren’t as robust as you thought they were. For example, there aren’t any appointment reminders in the scheduling module, or you thought you’d be able to pull more types of clinical reports.

In certain cases, you might be able to supplement your current system with a third-party best-of-breed software solution. These are individually sold products that perform one function very well, such as e-prescribing software that you can use alongside your current EHR.

Alternatively, you can ask your vendor if they offer extra products that seamlessly integrate the EHR, such as practice management or accounting software.

A word of warning, though: Practices sometimes opt for more functionality than they actually need, partly because they’re preparing for government health care regulations (e.g., MACRA, MIPS) that incentivize EHR use.

Webster advises practices to think in terms of their unique needs, rather than stressing too much about federal health IT programs. “Think for yourself: What do you really need to take care of patients?” he says.

Consider sticking with the EHR if: You can upgrade your software suite or integrate a stand-alone solution for the specific applications you need.

Replace the EHR if: Once you’ve crunched the numbers, the cost of implementing stand-alone applications would be greater than just replacing the system with a more robust one.

Challenge 3: Poor Customer Support

A vendor’s support services can make or break customer loyalty. Users are more likely to tolerate a hiccup in the system than an unresponsive health IT partner. One of our SERMO commenters agrees:

Not sure if your vendor’s support is subpar? Here are some red flags to watch for:

  • Long wait times to speak with agents over the phone (e.g., 30 minutes or more)
  • It takes days, or even weeks, for them to solve your issue
  • You have to explain your issue multiple times because they keep handing you off to a new agent
  • The support center’s hours are limited, and there’s no online case submission

This is so important to practices that we wrote an entire research report identifying the five top-rated EHRs for customer support. The real user reviews we based this report on provide valuable and unbiased feedback.

Webster says vendors will often “cherry pick” practices to provide customer testimonials during the sales process. The trick, he explains, is to look for sources with a more objective point of view.

Consider sticking with the EHR if: There’s more than one way to troubleshoot an issue. For example: If it takes too long to get a support rep on the phone, maybe there’s an active community forum hosted by the vendor where other users have addressed your query.

Replace the EHR if: There are little to no resources for DIY troubleshooting, and you’re fed up with the lack of attention from the support team.

Challenge 4: It Can’t Grow With You

This is another big reason we often hear from practices considering a new EHR, particularly those in the process of hiring doctors with different specialties. The system may be fine for the internist who founded the practice, but it’s not working out so well for the gastroenterologist who just joined.

“This is an especially thorny problem,” says Webster.

Software that enables specialty-specific note templates can help by providing each physician the information they need in an easily accessible format, but sometimes that’s just one small solution in the face of a bigger challenge.

Maybe the system does a poor job of sharing patient data among specialists or the interface isn’t user friendly enough.

The best way to make sure everyone in your growing practice is adapting well to the technology is to have new staff weigh in early and often.

Make it a point to address health IT issues at every regularly scheduled staff meeting. Over time, you may feel like the group has outgrown your EHR and needs something more sophisticated to streamline operations.

Consider sticking with the EHR if: The system provides specialty-specific note templates for the new doctors you employ.

Replace the EHR if: You’re getting mostly negative feedback from new hires, which is starting to affect care quality and morale at the practice.

Challenge 5: Updates Are Few and Far Between

No matter how incredible the EHR may have seemed when you first bought it, you want a vendor that is committed to continuously improving their product.

Vendors have long been accused of not being innovative enough and prioritizing profits over usability. You want to work with a company that defies those stereotypes.

You can tell whether an EHR company is forward-thinking by their approach to software updates. Think about how often your vendor issues them, how they teach you about new features and whether they charge you for each update.

This will be increasingly important moving forward as patients start expecting more tech integration in all facets of their care and digital data analytics play a larger role in health care payment models. You need an EHR that will keep up with these changes and gives you the tools to succeed.

Consider sticking with the EHR if: You’re satisfied with the product, even though you have to pay for updates yourself or they don’t come as often as you’d like.

Replace the EHR if: You’ve been promised updates before, and the vendor rarely delivers. For example, if ICD-10 codes haven’t been added or the product still doesn’t meet meaningful use stage 2 criteria.

Finding the Right Replacement EHR

Hopefully the advice in this article has helped you decide whether you’re ready for a new system. If you do decide to seek out a replacement, here are a couple of factors you need to consider:

  • Data migration costs: At some point, you’ll need to extract the data from your current EHR and port it over to the new one. Be aware that some vendors charge $30,000–$50,000 for this service.
  • Implementation time: You should work closely with the new vendor to agree on milestones for the rollout and a final go-live date. Some will assign you a dedicated implementation specialist. Prepare to lose some productivity as your team adjusts to the new software. Experts often recommend setting aside three months of capital to maintain your finances during the transition period.

Of course, the final decision on whether to replace your EHR is entirely up to you. But that doesn’t mean you’re in this alone. We’ve advised hundreds of practices across the country in your situation.

Just fill out this quick questionnaire to get matched with up to five systems that meet your needs and budget.

Alternatively, you can browse through hundreds of EHR product profiles on our website that include those all-important user reviews.

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