RECs Cart Before the Horse

Sorry if you’re bored, but I’m still completely obsessed interested in the RECs and how they’re using millions of government dollars. From what I’ve seen most RECs are really getting the cart before the horse.

From what I’ve seen most (if not all) of the RECs are out their doing RFPs with various EMR vendors and they are trying to narrow down their list of EMR vendors that they’ll support. Ok, yes I know they’re going to support all EMR vendors, but there’s going to be a different level of support for those EMR vendors for whom the RECs do group purchases with and “promote” in their REC.

I just don’t see what kind of RFP a REC could be sending to an EMR vendor. How would an EMR vendor even respond? Does the RFP say, we need an EMR vendor that can support big clinics, small clinics, solo docs. We need an EMR vendor that supports every specialty. We need an EMR vendor that supports…oh wait, the RECs don’t really know what type of clinics are going to be interested in our services and so how can they select an EMR?

Should RECs ask their constituents which EMR software they should try to support instead of the RECs unilaterally making a decision?

Let me offer a simple plan that would be much more effective:
1. Educate the providers in your area on the EMR selection Process. Use vendor neutral materials (Shameless Plug: like my EMR selection e-Book) to teach physician’s offices the best way to select an EMR.
2. Let them all go through the EMR selection process with the best practices the REC provided and take a survey of which EMR software each clinic selected (possibly their top 2).
3. Based on their decisions, negotiate with the EMR vendors that have a large number of clinics interested in using their software.

Not only would the RECs be getting GREAT feedback from end users on the right EMR vendors they should be talking to, but it would also put them in a great negotiating position with the EMR vendor. They would go to the EMR vendor with a list of clinics interested in that software product.

The biggest question with this plan is will the government stimulus money allow these RECs to go through a process like this?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, 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,, 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.


  • The RECs will choose EHRs for Public Hospitals, Community Clinics, and “safety net” PPCPs. Many hospitals and clinics are already using EHR or are in the process of choosing one. The “saftey net” PPCPs, 30% of their patients are Medicaid, are the providers that will be targeted by the EHR vendors. If these PPCPs belong to Medical Groups/IPAs, they will be steered toward whatever EHR vendor the Group has a relationship with. In California, Sutter, HealthCare Partners and Hill Physicians will be pushing NextGen. It’s the doctors that do not have a large share of their members in these Medical Groups that will be choosing EHRs. The market will not be as large as everyone thinks. The only stimulus that will be happening is that RECs will have employees that we the taxpyers get to keep employed.

  • Hi John, thanks to you, we were able to get the OHIO RFP on time and submit it back as well. It was a detailed RFP and had some pointed questions to answer. My guess is RECs are doing at least the preliminary work for the Physician community by checking/doing due diligence on vendors.
    Once again thanks to you and if you have information on any other RECs issueing RFP, please keep us informed. Yes I did contact CA folks and they were good in their responses; they are apparently couple of months away from RFP process.

    Anthony Subbiah

  • RECs should spend more time acquainting themselves with what SaaS technology is and translating the benefits of SaaS to the physician. Little to no emphasis has been placed on this technology, preferring rather to label it as hosted or ASP technologies. It is neither, yet it is perfect for the smaller physician groups that do not want to sacrifice functionality for price. Not every system is the right system for any given physician practice. My vote is to give physicians the ability to participate to a greater extent in the selection process. In my opinion the value that the RECs can play is to develop comparative matrices and allow the physicians to shop for the solution that best fits their needs. It’s similar to the established mini-mall concept for buying cars. Evaluating vendor capabilities, strengths and weaknesses might best be done when comparing each vendor’s approach, side by side.

  • Hi Gary,
    I’m obviously with you on physicians having more involvement in the EMR selection process. Although, that would make too much sense.

    I’d be interested to hear how you define the difference between SaaS, hosted and ASP technologies and their associated benefits and challenges. Basically, get past the textbook definitions and what’s the differences doctors should look for in those 3 names. You can even send it to me as a future guest post:

  • In regards to point 2. I think REC need to provide tools that will allow a practice to make an educated evaluation.

  • Carl,
    I agree 100%. That’s why I find it so odd that they are essentially selecting preferred EHR vendors already. They haven’t even gotten information on the needs of their physicians and they’re already making these decisions.

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