EMR Vendor Software Test Drives

As is often the case on blogs, some of the best commentary is happening in the comments. This has never been more true on this blog than this week. The comments have been thoughtful and there’s been some really interesting back and forth discussion.

One example of a discussion that began in the comments is around the benefit of being able to be given a demo EMR system that you can sit down and try. I’m not talking about a demo of the EMR software by someone (often a sales person) from the EMR vendor. I’m talking about a real life system where people on their own can go around and try out the EMR software.

There are so many things involved in this discussion that I’ll just throw out a few ideas and let the discussion continue in the comments. Do you load the demo EMR software with data or no? In some ways it’s better to have exactly what they’ll give you so you have an idea of how much you’re going to need to configure when you get the system. In other ways it’s better to have one loaded with the configurations, a few patients, lab results, etc so you can see what’s possible.

Certainly there are some challenge with certain platforms being able to easily provide a demo install. Large organizations can often do this, but small organizations might have a harder time getting a demo install. This is harder with client server EMR compared to web based EMR software. However, with virtual machines and other technologies, there are a lot of interesting possibilities.

I know one organization actually does what they call pilot installs where they install the entire system for you and will take it out if you don’t like it. You don’t pay until after the pilot period. I’ll add in more details about this vendor in the comments. Are there other creative ways to demo an EMR vendor before buying?

Ok, that should kind of get the juices flowing. Let’s hear your thoughts about EMR vendors providing a demo system for people to “test drive” before purchasing the EMR. I’d also love to know which EMR vendors provide this and links to their demo system would be great as well.

So, those of you who have been lurking on the sideline. Check out the comments and why not add one of your own.

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.

35 Comments

  • John,

    Our policies include:

    (1) full use at no charge
    (2) some test data optional
    (3) “you don’t pay until you get paid”

    In other words, if ARRA is an issue for the provider, they can wait until they confirm meaningful use.

  • I think this post is very true.. As far as the question of data or no data in the demo, it should be up to the customer. WebDMEMR is a low cost web based system so it is easier to access a demo, (i.e. no download needed) WebDMEMR offers the following options to prospective clients:

    1. Data Populated Demo – easily accessible email me at lroman@webdmemr.com for demo account info.

    2. 1 month free trial – no data, completely unused EMR so that users can determine if WebDMEMR is the right fit for thier practice. Follow the link below to sign up as a healthcare provider. (No commitment involved.)

    https://secured.webdmemr.com/NEWVERSION/signup/HCPsignup.aspx

    3. We offer WebDMEMR to customers with no commitment. We know that sometimes, after using an EMR, even a great EMR, you may determine that it is not the right “fit” for your practice. WebDMEMR does not rope subscribers into contracts. If they decide WebDMEMR is not right for them, we export all of thier previously entered data, and return it at no additional cost.

    Finding the right EMR is hard enough. Why make things even harder for our customers?

  • I think it’s safe to assume that the above listed trials are all done for free with no money up front. That’s very different than paying the money and then a guarantee that you can get it back if people don’t like the software.

    Plus, there’s no “restocking” fees either? I think I’ve seen an EMR or two that would do that.

    I’d love to hear more details about how people do the trial when its not a web based EMR as well.

  • Lourdes,
    In what format do you export your data for the doctor? Will you provide this export regularly for the doctor so that they have a backup of that data which they can retain themselves?

  • I’ve created a case in our project management system to create a demo version of DoxCIS that our potential clients could download and use experimentally. We’ll link to it in the wiki when it’s available.

  • AmazingCharts lets you use their system for as long as you want. You get to load up to 10 patients to work with and experiement with.

  • If EMR Vendors are worried about doctors not being able to use their systems without training, then they should produce training videos which the doctors can view for free!

    Many Vendors make a significant amount of their profit from live training, so it is not in their interest to provide these type of training videos.

  • Dr. Epstein,

    I have to agree. Furthermore, if a product requires significant training, then it was likely not designed very well to begin with. A good test of the overall quality of a software system (including “what’s underneath the hood”) is the basic UI, flow, and look ‘n feel.

    The previous statements were made with the following qualification.

    Admittedly, PM/EMR is complex, but the issues of UI, workflow and usability vs. utility have been persistent problems in large part because the tools and platforms have not been available to HIT until very recently.

    A little unfair in a sense for the govt to mandate structured data (and bunch of other things) from an unstructured world in such a short time frame. Even CMS knows you can’t solve a software problem by throwing more money at it.

    FULL DISCLOSURE: HIT vendor

  • Lourdes,

    Just noticed your post. Good ideas re: data and the approach. It’s really time for HIT to come together in support of the provider community and not to add another worry.

    We are working-up some sort of continuous data copy policy so the provider using our ASP/cloud model has basic assurance that they have their hands on their data at all times.

    FULL DISCLOSURE: HIT vendor

  • John said,
    “Iā€™d love to hear more details about how people do the trial when its not a web based EMR as well.”

    Our system design plans call for cloud host or local host. We expect some providers will NOT want their data in the cloud. Also, redundancy, fault tolerance, connectivity, performance might lead an office to want a local install. In fact, they could get the program from the cloud, but store/access data locally.

    Same policies apply. Provider doesn’t pay until they decide the sytem works for them. They set the criteria — ARRA, whatever. We trust them.

    As stated before, our business model has been specifically designed to forego revenue under the ARRA timeline and to “wait out” the fremiums if need be.

  • Axeo and Lourdes,
    What do you think about creating a movement where hosted EMR providers (SaaS, ASP, cloud, etc) commit to regularly providing practices their data. We could establish a set of criteria that you must meet. Then, if you agree to it, I could audit that it’s possible and reasonable with your technology to retrieve all the data. Then, you could get a badge showing that you comply with the practice of the data being owned and accessible by the practice. Maybe as part of the audit I also provide a description of how the data is outputted and the pros and cons of such output.

    Just brainstorming here. Seems like it could provide some value to encourage a movement around securing a practices data against a “rainy day” otherwise known as EMR mergers, EMR bankruptcies, etc etc etc.

    I’d be interested in hosting this type of movement if you guys are interested in helping to get it established. Seems like it would be a great PR move for your companies as well.

  • John,

    “you da man”; we’re in

    Our position is that the provider owns and controls THEIR data at all times under any conceivable circumstances including non-payment. We are working on internal policies and procedures whereby the provider has assurance they have their data in their hands in a reasonably useful format on a daily basis if they so desire.

    Your program calling for outside audit is understandable and acceptable to us.

  • For technichally challanged physicians, could someone provide a simple explanation of “THE CLOUD”?

    How does it work? Is it your data or the program or both? Where is the cloud hosted? Is it in “the ether” or on a computer in a vault under a mountain in Arizona?

    BTW, the bright star in the south at bedtime is the planet Jupiter. The brighter star in the east in the morning is the planet Mars. The other bright star in the morning in the South is the planet Uranus.

  • Be careful with revenueXL -they display the CCHIT 2008 logo but are NOT listed at CCHIT – even though they tout the value of bing CCHIT certified!!!!

    Medscribbler will install and you pay after it is working for you. There is access to a full server with real anonomized patient data. We can get you a Tablet on loan to trial. Start with a demo first though because it is actually a training to now what to look for in the trial.

  • Dr. Epstein,

    Origins of the term are varied, but if you think back to some early office diagrams of PC/LANS, the connectivity to the Internet was often shown with what appears to be a cloud drawn around the word, Internet. We have a section on our Web site addressing the issues.

    Today, “cloud computing” is more of a concept or paradigm than a technology. Cloud vendors talk about “abstracting complexity” at various levels for the end-user. IT services provisioned more like your electric utility — you plug into the grid (the Internet) to access various services (programs, data, services, support, etc.) on a subscription basis vs. the local desktop/PC/LAN hardware and software license model.

    Like on-line banking, generally the program and your data reside on the banks cloud infrastructure and you access the service over the Internet using a Web browser. Often times the bank (as an example will outsource their cloud infrastucture system to another cloud vendor specializing in data centers.

    As more complexity is abstracted away (or so the vendors say), terms like SaaS and ASP are used for vendors that provide their software only or primarily from the cloud. Again they usually outsource their infrastucture to a specialist.

    Feel free to call me if I can help here.

    — Jack

  • John,

    As to the data issues — where it is and who controls it. We have what we call Provider Bill of Rights policies under development.

    The data issue is addressed. Also, we will not withhold support, upgrades, or prevent access to the systems even in the event we are not paid for some reason.

  • Practice Fusion allows free, instant access to our EHR anytime for any medical practice. https://secure.practicefusion.com/pf/practicemanagementsignup.aspx?pt=4

    Anyone who signs up for our system is delivered credentials for the complete suite of features in seconds. The user can then login, test the system with a few sample records that come pre-loaded or start charting themselves. If they decide to continue with Practice Fusion’s free EHR, there is nothing to switch, install or license – they simply keep using the version they signed up for. If they decide not to use it, they can either close their account or just not return. We also provide free support and live training for all our users.

  • John said:
    “Lourdes,
    In what format do you export your data for the doctor? Will you provide this export regularly for the doctor so that they have a backup of that data which they can retain themselves?”

    Since we use MS SQL 2008, we can export in any of the primary database export formats. All encounter printouts and reports are in PDF, All uploaded documents are returned in the same Format as they were entered

    WebDMEMR’s development plans include a download module so that Patients, Healthcare providers & Site Administrators can download thier own data for disaster recovery and back-up purposes.

  • Jack, sounds like the “cloud” is housed in a climate controlled facility that houses servers. Am I correct?

    After a one hour demo provided by a sales rep (a guided tour), the Vendor should provide a demo version for the physician along with a training webinar. The training webinar should be no longer than one hour and should provide the basics to document a progress note.

    The physician should then be given the option to do more training webinars and further explore the demo version.

    EMR’s should be designed to work “like” microsoft office programs! This will make them intuitive and easy to learn.

    This all seems so obvious to me.

    I would not settle for anything less than this.

    Providing access to demos on the web IS NOT GOOD ENOUGH! Too much trouble to sign in each time! I want it on my desktop!!!

  • Yes, but climate controlled data centers are just part of the puzzle. Data center vendors are considered in the cloud. The term, cloud now used loosely as a metaphor for the Internet.

    The term, cloud computing, is a much broader concept and encompasses a variety of vendors, products and services with intertwined horizontal and vertical relationships.

    As always, holler if I can help. I hope I don’t confuse or raise more questions than I answer.

  • Dr E,

    A theme that appears to be developing by the tone of a number of posts here, is providers feeling they are being “held hostage” or “captive” in some ways by their technology and tech vendors. Sounds like John is making inroads along those lines. Correct me if I mis-understand.

    As to intuitive and easy to learn, I agree. Since there are so many different ways to do charting, tough to computerize in the same way HIT has tackled accounting and billing for example. IMO, therein lies at least part of the problem.

    — Jack

  • Axeo,
    I think the concept of a Provider Bill of Rights is the right idea. Not to mention the Bill of Rights concept is in vogue. The question is what is the best way to come about creating this provider bill of rights and governing those vendors that want to adopt and represent those values in their software.

    P.S. You’re EMR scout website doesn’t look good at all in Chrome (the browser of champions)

    Dr. Epstein,
    I disagree that having a web demo with a login is not enough for those that want to demo an EMR. It doesn’t make any sense to have a web based product somehow be ported to your desktop. If you have problems logging into a demo account to see if you like it, then you’re likely going to have a problem with an EMR in general.

  • John,

    Re: DrE and his demo comments. The Web can be painfully slow sometimes. UI success or failure for some can literally be a matter of seconds. Sounds like DrE would demo or use a system in the cloud but just wants his multi-media training materials locally for quick access and speed.

  • Thanks, Jack!

    Plus, you sometimes want to play with the demo in your car while waiting for your kid at football practice or you want to start the demo and do a little at a time and not get timed out OR you may want to do it in an airport where you don’t have internet connection.

    Convenience is very important and time matters!

    Jeff

    As far as the EMR Bill of Rights does. Just write it! We can write it on this blog. Common Sense must RULE!!!

    Let’s start an EMR Bill of Rights Thread!

    First Amendment: The EMR must be easy to use, simple to learn, affordable and it must save the physician TIME!

    Second Amendment: The right to get your data back or transferred to another system at a low cost.

    Third Amendment: The right to demo the EMR with up to 10 patients for as long as you want before purchasing.

    etc

  • I again looked at the website of RevenueXL. They are not a product company. RevenueXL is a revenue cycle solutions company that helps providers select the right-fit EMR. Check out http://www.revenuexl.com/free-emr-consulting/. Not sure where CEOMike is coming from. It seems like RevenueXL works with many companies like Medscribbler who have CCHIT certified solutions.

  • DrE (hope you mind the shorthand)

    We could say DrEE and then you would also be an electrical engineer. šŸ™‚

    Tough for me to chime in sometimes because it will sound self-serving, but I agree with you on many levels. Note that I would help providers and cooperate with other vendors to a common goal.
    Look, if a vendor install got into trouble, and the provider did not want to “rip ‘n replace” for obvious reasons, AXEO would help-out just to avoid a black mark for HIT in general, even though we would not get the account in the end.

    As I stated earlier, we have a Provider Bill of Rights in the works.

    Your #1: agreed, tough but not impossible IMO

    Your #2: yup, but see my posts re: “idiosyncrasies” of HL7 in vendor databases; so, this one easier said than done

    Your #3: I can only speak for AXEO, but you will get our system, no charge, complete for as long as you want. You set the criteria — ARRA funds, whatever, up to you. We trust you. Been in HIT for over 25 years and never not been paid.

    — Jack

  • AXEO,
    The web might be painfully slow, but to me that’s a major part of the EMR evaluation process if you’re choosing to evaluate an SaaS EMR solution. Buy a mobile broadband card if you want to try it at your son’s soccer game;-)

    Jeff,
    I think that goes beyond the scope of what I had in mind. Although, that’s an interesting train of thought. My thought was to create a Provider Bill or Rights related to SaaS EMR and availability and vendor lock in of their healthcare data. Basically, if an EMR vendor commits to making the data in their EMR exportable in a reasonable fashion, then 1. it protects a doctor against something undesirable happening to the EMR vendor (and the doctor’s data) and 2. it forces the EMR vendor to create a great product that people can’t live without, because if the data is portable, then they can easily switch to a new vendor if their current EMR isn’t cutting it.

    Point being that I think we need to focus on something smaller and achievable and then we can expand it to more things. Better to do something smaller and valuable than to try and do everything and end up doing nothing.

  • Let’s do both!
    We have unlimited resources with your audience.
    When our founding fathers founded this country, they did big things and small things at the same time. You have to design the framework (the rules of the game) for EMRs so Vendors can know what will make their EMR indispencable. Sorry about the spelling šŸ™‚

  • John & DrE

    One way to look at it based on your comments is maybe a Provider Bill of Rights and a Vendor Code of Conduct.

    To an extent, the space has now been “nationalized” by the US Gov and some posts appear to be almost calling for regulation and oversight.

  • “We have unlimited resources with your audience.”

    If that were only true it would be great.

    I’m going to be thinking over the weekend on this and put together a proposal. I think we could do some pretty cool things.

Click here to post a comment
   

Categories