Who do Doctors trust in EHR Selection?

Anne Zieger has a really interesting post about Hospital Recommended EHR software over on Hospital EMR and EHR. In it she talks about how most doctors don’t take the hospital recommended EHR software. This will come as little surprise to doctors and likely to hospital systems as well. Doctors and hospitals have always had a mixed bag relationship. There’s this odd co-dependence that usually makes the relationship awkward.

When it comes to EHR adoption, physicians love the idea of getting IT and implementation support from the hospital. They also love the group buying power. Although, they also are concerned that they’ll just be a small fish in the big hospital waters and not get the support that they think they deserve (and maybe they do). Although, the most important reason doctors don’t want to get the hospital recommended EHR is they don’t want to create that “permanent” tie to the hospital. Of course, this is one major reason why hospitals want doctors to take their recommended EHR.

If we can say that doctors don’t trust hospitals recommended EHR software, then who do they trust?

That answer is easy: other doctors.

There’s something really powerful about the trust connection that doctors have between themselves. I’m sure there’s a number of factors that contribute to why they trust doctors more. It probably goes back to the bond that going through medical school creates. Reminds me of when my brother described how boot camp in the Marines created a unique bond between Marines. Doctors seem to experience a similar bond around medical school. Even if they’ve never met before, they can connect sharing “war stories” from their medical school and residency experience.

In many cases, their physician colleagues are a great reference pool for them when it comes to EHR selection. This is particularly true if their colleagues are in the same specialty and have a similar practice size. Although, once doctors start talking to colleagues from different specialties or different size institutions then they often run into trouble. The EHR that works for a 100 office multi-specialty clinic likely won’t be the right one for a solo practice.

IT Service Companies
I also believe many practices have a great trust in their IT service provider. You can see this trend in how many IT service company employees comment and subscribe to this site. Plus, many of them offer some sort of specialized EHR service to doctors. In fact, many are VARs for EHR vendors.

Internet EHR Info
Turns out that most doctors are very independent thinkers. So, many of them want to do the EHR selection on their own. This leads them to the internet to search and narrow down the list of EHR companies. I expect the internet resources for EHR are probably now the most influential part of a physician’s EHR selection process. Can you imagine a physician selecting an EHR without online research? I can’t.

Who else do you see influencing the EHR selection process?

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.


  • John, you hit the nail on the head with those sources you mention.

    Just wanted to highlight that healthcare professional discussion lists seem to be a very active area of sharing information / influencing decisions.

    Maybe another source would be other service provider to the practice, if they are well respected, like medical billers. . . (they hear what doctors are raving / complaining about).

    Did want to comment also on why doctors may not sign up with the hospital:
    1: They may also have to subscribe to the hospital’s practice management system (PM), medical billing service. . . and all the dictated fees associated with those.
    2: If they sign up for the hospital system, they may become part of the “HOSPITAL SYSTEM” and therefore may not be eligible for government incentive payment because of the hospital’s sponsorship, support, funding. . .

    Great article!

    Good luck on your selection process and have a blessed day.

    A little free generic advice:

    1) Be wary of “free” – research what sources the vendor is getting their money from.

    2) Support is critical to success – watch where your support is coming from and what other practices are saying about it.

    3) Training and communications are just as critical as support – have plenty of both.

    4) A network / infrastructure review and upgrade plan may insure a smoother implementation success and return to workplace efficiency.

    5) Consider using a professional project manager to develop and maybe execute the implementation plan. Once you have a fumble within your practice, it’s harder to gain trust the next time around.

    6) Consider some of the “fringe” services / products that may be extremely helpful to becoming successful going electronic, ie: strategic medical record scanning, voice recognition s/w. . .

  • Hi John,

    Physicians are influenced primarily by the experiences of other physicians with goods and services. When they demo an EMR, they want to know:

    – who in my local area is using it?
    – who in my specialty is using it?
    – who in my group size is using it?

    They often reject the hospital product not only because they wish to remain independent, but also because they know that practice software made by hospital vendors is not scaled or designed to work the way doctors in practices do. Of course, they are getting better all the time, but the group practice software is an afterthought.

    The real reason the hospital software should be so appealing is the interface between all the parts of the integrated system – in my opinion worth the workarounds of the hospital software to get all the patient’s information when seeing them at any place or at any time in the system.

    Best wishes,

    Mary Pat

  • Good comment Mary Pat:
    “The real reason the hospital software should be so appealing is the interface between all the parts of the integrated system – in my opinion worth the workarounds of the hospital software to get all the patient’s information when seeing them at any place or at any time in the system.”
    and it is true if everything remains in the same health system.

    A personal experience I had as a patient just over a year back was I was clearing some heavy snow off a ladder and fell off, I was taken to the local hospital emergency, after some scans / exams they had to transport me to another hospital because they had a neurological ICU.

    The problem was these hospitals belonged to different health systems and had different EMR systems and both those EMR systems were different the my primary physician’s EMR. I ended up collecting CD and paper files from all of the hospitals and eventually providing the information to my primary physician. BTW, the first hospital faxed my scan / exam report to the other hospital while I was transported in the ambulance.

    I know SOMEDAY they will all work together but I wonder if I will live to see it. No permanent brain damage came from the fall so, Lord willing, I amy still be alive a while.

    In the meantime, I am working developing practical PHR solutions.

    Then what happens if a doctor sees patients in different hospitals that have different EMRs?

    Thanks for sharing the comment Mary Pat, I respect you views, subscribe to your newsletters and tweet a lot of your stuff! Keep up the great job.

  • Mary Pat,
    That is why many end up going with the hospital EHR system – The connection to the hospital system. Although, sometimes even then it doesn’t work quite like they would like it to work.

    Let’s hope it happens in our lifetime. The sad part is that the technology is there to do it. Just money and bureaucracy standing in the way.

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