Will Rip and Replace EHR Software Ever Be a Thing of the Past?

I heard an interesting statistic a few days ago during a very informative webinar – “The Future of Meaningful Use, EHRs and Accountable Care” – hosted by Greenway Medical’s Justin Barnes. He shared a huge amount of information during the hour-long presentation, but the fact that most stood out to me was that, according to Barnes, between 35 and 50 percent of EMRs will eventually be replaced after just one year of use. (Don’t quote him on the “year,” but I’m pretty sure that’s what he said.) His point being, of course, that providers need to think long and hard about what type of solution they need to fit their workflows before they spend time and money implementing an EMR.

This sentiment was echoed by Kimberly Harding of BCBS Florida in a panel at the iHT2 Summit in Atlanta. As part of a greater discussion on Meaningful Use, she made the comment that just because a healthcare IT product is certified doesn’t mean it’s the best fit for a particular facility.

My takeaway from both of these statements is that providers looking to adopt new healthcare IT tools like EMRs need to take a long, hard look at what their current needs are and what their future needs might be before they even think about demoing products.

They also need to adopt technologies that fit their workflows, not necessarily technologies that have a ton of bells and whistles. Added features won’t do anyone any good if they’re never used properly, never used at all, or used to the detriment of a physician’s productivity.

I kept this sentiment in mind when I read the results of a recent study of 250 hospitals and healthcare systems by consulting firm KPMG. The survey found that “71% of respondents’ organizations are more than 50% finished with their EHR adoptions. Will this 71% be satisfied with their EMRs once fully installed and adopted? How many will realize their product of choice wasn’t the right call? If we apply the Greenway statistic, that could be as many as 125 facilities!

So where is the disconnect? Why are providers making poor choices with presumably the best of intentions? Why has the term “rip and replace” become so well known in healthcare? Are physicians misinformed, or not educated enough? Are they feeling so rushed by Meaningful Use deadlines that they don’t perform proper due diligence? Are vendors part of the problem? If so, shouldn’t they be part of the solution? What role do regional extension centers have to play in all this?

If you have answers, please let me know in the comments below.

About the author

Jennifer Dennard

Jennifer Dennard

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.


  • I think there is far too little transparency in the industry. If vendors were more forthcoming about the costs and liabilities, there would naturally be fewer disappointed providers who pay for the products.

  • I think that the three big factors that drive EHR “Churn” and they are identical to what we as individuals go through in looking for a mate.
    1) Attractive – Does it “Look Good”?
    2) Performance – Does it give me what I want now?
    3) Compatibility – Will it continue to give me what I want in the future as we both change?

    Well “Beauty is in the eye of the beholder” so every individual is going to have a different opinion on #1) So in a practice where there is more than one person, there will be more than one opinion.

    Performance is also highly individualized, the providers definition of performance will be entirely different from the billing staff’s definition of performance.

    Compatibly issues are what cause the “divorce”. If the product cannot change daily to accommodate the rapid changes driving our market for each individual person in the practice the pain and suffering will reach a point that even the marginally happy users will conceded to a replacement.

  • Agree with the above commentors; in our experience, we have a few instances where we have replaced existing EHR installs; mostly the EHRs were already 3 to 4 years old and the Provider (we are talking about Ambulatory Care) was debating to buy the upgrade which is certified or go with another system. Moving from one system to another is a difficult decision because of the time and effort – more so than the raw cost.
    Many of them live with the constraints or learn to work around it.
    By nature, we are all resistant to change and that’s another reason that rip and replace will happen only in extreme situations.

  • The far more interesting question is what do those practices do a year after they’ve installed their second EMR?

  • Al Davis,
    My anecdotal experience is that those doing their second EMR are much more successful. There are a few cases where they hit the third, but that’s pretty rare from what I’ve seen. Those going for their third EMR have other issues I imagine.

  • A third EMR? I can’t imagine that ever happening in social services! I’ve been listening to some of the EHR webinars, and almost every time someone asks about funding sources.

    One factor in choosing an EMR that could contribute to the disconnect is the promise of enhancements by the vendor. How quickly do they respond to client needs, esp. outside meaningful use?

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