Back to Blog

The 4 Big EHR Implementation Challenges Small Practices Face!

22 April 2014

Electronic medical record (EMR) systems can offer real benefits to health care providers of all sizes, but small practices face challenges larger providers can hand off to an internal IT department or external consultants.   Here are a few of the biggest challenges and how they can affect your practice.


The Department of Health and Human Services (DHHS) has mandated health care providers that receive payments from Medicare and Medicaid prove “meaningful use” of an EMR that fits certain criteria by 2015. If the practice does not meet the deadline, they face reduced reimbursement. DHHS also provides a financial bonus to help practices reduce the costs of installation and upgrades. This “carrot and stick” approach has put health care providers into the position of making choices quickly, but choosing the wrong EMR can actually cost more than the incentives.


>There are many EMR solutions out there, and not all of them fit every practice. An EMR designed for a general practitioner may not be suitable for a specialty practice such as embryology or urology. While many EMRs feature options or special packages to make them friendlier to practices in specialty fields, some vendors have extra charges for simple customization. That’s a cost above the  basic cost of the EMR itself. Others EMR vendors may require the practice design their own templates, forms and workflow.  Small practices usually don’t have the knowledge or manpower to create these templates themselves, forcing them to hire outside designers at additional expense.


When a practice is part of a health care provider network, it’s important to ensure all the practices are using EMR software that can communicate the care record of the patient. A practice cannot take full advantage of all of the benefits of running an EMR if a referred patient’s records show up as a fax or in a manila envelope. In the past, vendors of proprietary EMR software have limited interoperability as a way of enforcing brand loyalty to their specific platform or product. The Patient Protection and Affordable Health Care Act requires EMR vendors to develop effective methods of transferring patient files. Unfortunately, some vendors have been dragging their feet in the interest of protecting profits.

Sharing too much data can also be a problem. Patient privacy laws demand practices keep patient records confidential and only transmit information relevant to the issue at hand. If a patient visits an emergency room at an unfamiliar hospital for a trauma wound, their blood type and medication allergies are vital information. Their history of cataracts, may not be.  Sharing non-relevant details can get a practice in trouble very quickly.


The changeover to new and unfamiliar systems always brings some disruption, but small practices often face challenges from employees with different levels of technical expertise. One staff member might be a “hunt and peck” typist with a 10-year old computer at home, while another types 100 words per minute and always has the latest device in their hands. Practices must make sure each employee receives adequate training so they feel comfortable enough to perform their duties with speed and accuracy. The cost of inadequate training is not only loss of productivity and billable time, but mistakes that can affect the health and care of the patient.

ZH Healthcare’s ZH OpenEMR solutions help small practices overcome these challenges.  The ZH Healthcare solution is cloud-based, secure and certified allowing emphasis on how the EMR can be best tuned to the needs of the practice.  Emphasis is put on customization, training, and workflow optimization with the purpose of getting the practice up and using the EMR within 30 days of project start.  Small practices have reported success in the implementation and training of their staff (see these small practice success stories).