Everyone gets so excited and worked up about the initial EMR implementation, but so many discount the effort that’s required for every EMR update cycle as well. Dr. Jayne from HIStalk gave a great first person perspective on EMR update cycles:
I figure I’ve got about two weeks of the good life left and then I’m going to be back in an upgrade cycle with all the standing meetings that entails. I’ll be back in the trenches testing workflows and trying to find defects as quickly as possible so that our vendor can roll them into patches before we go live. Every time we upgrade it reminds me more and more of some kind of military assault. I’m not sure if it’s just the way we run them or a little bit of post-traumatic stress. Maybe it’s a little of both.
I’m also reminded of Heather Haugen’s comments about EHR upgrade cycles: “software upgrades erode adoption over time and so with every upgrade you need a commensurate effort to retrain adoption.” Far too often organizations underestimate the impact and challenge associated with EMR upgrades.
Over the next couple years, those upgrades will likely be tied to an organization’s meaningful use plan. So, those will likely go better than some nebulous EMR upgrade plan. However, those organizations who underestimate the impact of EMR upgrades on their organization will pay the price later.
I know that many believe that in the large hospital space it’s a two horse race between Cerner and Epic. However, when you consider the challenges and costs associated with upgrading those software, don’t be surprised if some smaller scrappy startup can exploit the EMR upgrade opportunity. I don’t think it will happen until after meaningful use and EHR incentive money run their course, but it will happen.