EMR Motivations

I’ve been thinking quite a bit lately about the impact of the EMR stimulus money and how it’s changed the EMR world. One of the big changes is the motivations people have to adopt an EMR. With $36 billion of stimulus money, things have changed. I even went so far as to create a post called “EMR Is About the Money.”

Turns out that CIO, Neal Ganguly, agrees with me, but described it in a much more politically correct way in his listing of the EMR drivers:

  • Physicians: Primary Driver = Stimulus dollars; Secondary Driver = Easier access to data; Tertiary Driver = Better outcomes / continuity of care
  • Hospitals: Primary Driver = Stimulus dollars; Secondary Drivers = Strengthen physician relationships / Fear of reduced reimbursement; Tertiary Drivers = Better outcomes / continuity of care
  • Government: Primary Driver = Reduce costs by eliminating waste and redundancy; Secondary Driver = Better outcomes / continuity of care; Tertiary Driver = Better data to analyze and drive ongoing health reform.

Does anyone disagree with these items? I’d love to hear it in the comments.

My only comment is that government doesn’t seem to have any drivers. To me it seems like they were just given a bunch of money for EHR and now they’re trying to figure out what to do with it.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • I am hearing a much louder message that, at least for now, the risks exceed the perceived $$ benefit for many physicians and hospitals.

    Until the government, but more importantly the industry, can adopt more standards and practices for HOW the EMR, EHR, PHR, HIE and everything else will work together – practitioners are not going to want to invest thousands or millions of dollars with the hope of getting some smaller percentage of stimulus return.

  • RE: Physicians: Primary Driver = Stimulus dollars; Secondary Driver = Easier access to data; Tertiary Driver = Better outcomes / continuity of care.

    Has not the physician user base already “voted with their feet” on items 2 and 3? Prior to talk about stimulus dollars about 95% of small physician practices had already determined that an EMR didn’t provide 2 or 3 – at least not to the extent that it made up for the loss of physician time spent working with it.

    So we’re just left with # 1 and ambiguity about who can qualify for it. The stimulus has served to put the question about getting an EMR back into the minds of physicians – it is yet to be seen what impact it has on getting EMRs installed and used by them.

  • Lets look at the price over 5 years for some of these EMR/PM systems. I’m looking at one for a solo cardiology office and am blown out of the water by the cost. alscripst emr 27540. over 5 years, allscripts emr and pm $35460 over 5 years, e md over 5 year for pm/ emr 35, 059, chartmaker over 5 years 28,190.

    Can anyone suggest a good solution that is CCHIT certified and good for ambulatory cardiology??

    John Hakim

  • Brad and Russ,
    Thanks for your fine comments.

    First, I’m not necessarily saying that these motivations (ie. the EMR stimulus money) are going to be enough to push the majority of people over the edge and implement an EMR. I didn’t say that, because I’m probably one of the loudest voices saying just what you suggested Brad. The vague possibility of EMR stimulus money is not a good enough reason to implement.

    More to your point Russ, I think that doctors did vote to a large extent on 2 and 3. However, I personally believe that before the ARRA EMR stimulus money rocked the EMR world, there was a shift in perspective of many doctors. The shift had gone from the question “Should we implement an EMR?” to “How, when, which, EMR should we implement?” Most had resigned themselves to the fact that it was going to happen. Of course, most weren’t in any big rush to do it yet.

    Yes, the jury is still out on whether ARRA will increase EMR implementations. My guess is that it will, but not to the percentages that they’d like it to be. I also think that most of the money will not go to those who don’t have an EMR today. Most of the money will go to those who already have an EMR. So, if the government’s point was to increase implementation it will generally be a failed program.

    The other low hanging fruit that I think is highlighted by John Hakim’s comment is I wonder if many practices will implement bloated, poorly designed EMR software in the hopes of EMR stimulus money. Then, they’ll hate the software, they’ll not get the stimulus money and then it will set the EMR adoption farther behind where it was before ARRA. Certainly not a forgone conclusion, but within the realm of possibilities to consider. My goal is to help as many people as possible to avoid this type of problem.

    I should also mention (in this comment that I should have made a post of its own) that I maybe shouldn’t have used John Hakim’s name above, because the fact that he’s coming to this website (and likely others) to make an informed decision means that he’s likely going to make a much better EMR selection decision. (yes, I know that’s a terrible run on sentence) John, I left a comment on the other post where you left a similar comment and dropped you an email if you’d prefer to converse in private. Also, thanks for the pricing. Very interesting.

  • Then, they’ll hate the software, they’ll not get the stimulus money and then it will set the EMR adoption farther behind where it was before ARRA.

    Based on my interactions with the healthcare community, this statement is the “crux” of the HIT challenge. Its no wonder that many physicians and practice managers have such a tainted perspective of IT when the healthcare industry is plagued with vendors who have such a short-term view of selling their product and moving on – leaving the practice to figure out the training and procedural changes needed to realize any benefits.

    Now, I am concerned that our government is joining this approach with its stimulus and healthcare plans. They provide some short-term incentives (and regulations) but have yet to map out a good foundation or long-term path for achieving this “vision”.

    Vison, no matter how motivating, cannot be achieved without a good strategy and realistic objectives.

  • Sort of makes you wonder, why if EMR and EHR are supposed to be so good for healthcare providers why they have to be paid to install them and penalized if they don’t.

    It reminds me of getting children to eat peas.

  • The single biggest risk factor for EMR implementation failure is you are doing it to “Go after the stimulus dollars”.

  • So DrM, you mean that those that are “going after the stimulus dollars” are more likely to have a failed EMR implementation? Sounds reasonable to me. Focus too much on the money and not enough on the change required to implement an EMR successfully.

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