In 2005, RAND Corporation released an influential report on Electronic Medical Records that predicted adoption rates up to 90% and health care savings of $81 billion per year. In a new report released in January 2013, RAND revisited the subject of EMRs and found an overall lack of progress. “We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” stated report co-author Dr. Arthur L. Kellermann. Let’s look at some of the factors at the root of the shortfall that have caused practices to rethink their EMR decision.
Interoperability is one of the biggest stumbling blocks facing clinics. In a report released in October 2012, the Bipartisan Policy Center found 71% of clinicians surveyed who used EMRs found the inability to share information between different EMR systems and the lack of supporting infrastructure were major barriers.
The costs of setting up and maintaining these interfaces and exchanges was the second most frequently cited major barrier at 69%. The 2013 RAND report found closed system EMR vendors have been slow to improve the interoperability because the inability to communicate enforces brand loyalty and locks facilities into buying their products.
A Black Book survey released in February 2013 found 17% of clinics surveyed were planning on changing their EMR solution within one year, and another 8% wanted to change but were unable to afford it. Black Book also conducted extensive phone interviews with over 550 practices to find specific complaints and track trends.
Lack of customization to a specific practice or specialty is a major issue with many clinics. With an EMR that fits into an established workflow the adjustment should be minimal and temporary. While the highest number of dissatisfied EMR users were specialist clinics, they also found 54% were small practices. Unfortunately, the report stated many EMR vendors were most concerned about backlogged implementations and selling product. Development issues and customization options at many vendors were ignored after the sale.
The Black Book survey found the most important factor in the decision to look for a new EMR was the failure of the existing EMR to meet the needs and fit the workflow of the specific practice. Amazingly, many EMR buyers blame themselves. The survey indicated 79% of the respondents who expressed dissatisfaction with their EMR thought they did not adequately assess their own needs before selecting their provider. This is not a failure of the buyer, it’s the EMR vendor’s responsibility to make sure the product will fit their client’s needs.
The phone survey also asked health care providers their top ten criteria for selecting their next EMR vendor. While interoperability and integration concerns ranked high on the list, vendor viability came in first at 84%. Clinics need to be sure their EMR vendor will be there supporting their product for the long haul and fulfill their side of the bargain. Some health care clinics have found this out the hard way, as delayed implementations and dropped products have caused them to lose federal support promised under the Patient Protection and Affordable Care Act.
The act provided economic stimulus funds to encourage medical facilities to adopt an EMR solution, but some EMR vendors have oversold or overpromised and not followed through. The New York Times documented separate lawsuits filed against EMR providers Cerner Corporations and Allscripts for accepting payments and not meeting the time frame or criteria for their clients to receive federal aid to pay for the system.
ZH Healthcare provides solutions that address each of the above issues.
ZH OpenEMR reduces the hassles of incompatibility by using health care standards such as HL7 and ANSI X12 EDI for billing to ensure interoperability. The hosted EMR solution from ZH Healthcare is infinitely customizable. The use of the Screenflow Customizer allows practices to implement workflow specific to your practice. The Go-Live process ensures your practice is utilizing the ZH OpenEMR solution within 30 days or less.