EMR Purchasing Question and Answer

I always like it when people ask me questions about EMR. That way, I know that I’ll be providing at least some value to someone. Brian asked the following question in the comments:
Do you know who actually makes the decisions to purchase EMRs? For example, at large hospitals or medical groups, is it CIOs, and in small practices is it physicians?

This is a really hard question to answer. In fact, it’s likely one of the reasons why making the EMR sale is pretty hard. Each organization is very different. I guess this is a byproduct of the capitalist society that we live in.

That said, in hospitals, it usually is the CIO that is making the final decision to purchase an EMR after the CEO’s approval of course. Although, many times the work of selecting the EMR software and going through the EMR review process is delegated to a committee of people in the hospital organization.

The medical groups are harder to analyze since they come in all shapes and sizes. Not to mention varying governance structures. I would likely define these practices in two categories: physician run groups and manager run groups. You can guess who makes the decisions in these two categories. With that said, the doctors can really make an EMR implementation miserable if they’re not on board with the EMR selection. So, even if the practice is not physician run, you better consider these doctors in the process.

Small groups are generally more heavily influenced by the physician’s choices. Occasionally you’ll come across a strong practice manager, but usually that person is strong because they know how to work well with the doctor and their needs.

Certainly there a lot of other variations, but this is generally what I’ve seen.

About the author

John Lynn

John Lynn

John Lynn is the Founder of 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.


  • This is not a comment but a question. I have heard from a couple of sources that a medical practice with fewer than 10 employees do not have to switch over to EMR. Does anyone know if this is true? I can’t find any information on this, and CMS has been of no help.

  • Marlene,
    The short answer is that No One HAS to switch to EMR. There could just be Medicare penalties for anyone (regardless of size) if you don’t implement a “certified EHR” and show “meaningful use.” Those penalties will start at 1% and move up to 3-5% over time. Of course, this is assuming that HHS actually imposes the penalties which some suggest they might not.

    Otherwise, at least as it is now (and likely into the future), there’s no requirement to use EMR regardless of size. With that said, there are a number of EMR benefits you might be missing if you don’t: http://www.emrandhipaa.com/benefits-of-emr-or-ehr-over-paper-charts/

  • John, excellent answer. From my experience, I agree totally. I think the only addition I would like to make is that depending on the segment (Hospital, CHC, solo/small), differences exist in the criteria they use to select EHRs. For example, solos and smalls really focus on the stability of the EHR vendor almost as much as price. Guess too many of them got burned or heard horror stories from colleagues about EHR vendors going out of business after they installed it.

  • Marlene- I doubt that being true, as I know organizations with less than 10 employees already using effective EMR’s and guess this would be the best and easy stage to start with too.

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