Have You Ever Tried to Cancel an EHR?

A caller’s attempt to cancel their Comcast service is going around the internet. About 10 minutes into the call, the husband got on the line and started recording the call for all of us to see how the Comcast retention rep acted. You can listen to it embedded below.

I imagine most of us have had an experience trying to cancel our service at one time or another. It’s not a fun experience. Although, I know some people who call to cancel their cable service every 3 months in order to have the customer retention representative give them a lower cost deal. You know that offering you a 3 month lower cost (or something like that) is one way they try to retain you as a customer.

As I listened to the call, I was thinking about some of the experiences I’ve read and heard about clinics cancelling their EHR service. Unlike a cable or TV service where it’s quite easy to switch services, switching EHR software is a much more involved process. In many cases EHR vendors hold you “hostage” more than the Comcast retention rep above.

In most cases, the EHR vendor will go radio silent on you or responses to your inquiries will take a really long time. Plus, when you ask for access to your EHR data, you’ll often get hit with a hefty price tag. It’s a shameful practice that many EHR vendors employ to try and lock their customers in and prevent them from switching EHRs. We’re entering the era of EHR switching and this is going to impact a lot of practices going forward.

I’ve debated for a while now creating an EHR “naughty” and “nice” list which outlines the good and bad business practices by EHR vendors. One of the challenges is defining what’s naughty and what’s nice. There’s a lot of grey area in the middle. Although, I think that aggregating this type of information would be really valuable. I’m just afraid that many EHR vendors won’t want to share.

I’ve written posts before about why I think holding a practice’s EHR data hostage is a terrible business practice. The medical community is small and an EHR vendor that tries to do this will definitely suffer from negative word of mouth. What do you think? Should we create a list of EHR vendors and their policy on EHR cancellations?

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.


  • You should definitely post a naughty or nice list (if you’re able to attain accurate info from the EHR vendors). I would be surprised if there was more nice than naughty though, given my experience in the past with other EHR vendors, especially for small independent practices. They know that they have you hook, line, and sinker once you’re committed and even if you are even thinking of changing, just the transition fee alone will sink your practice, so most don’t bother changing and stay unhappy with their system and their practice.

    You can count my open source EHR implementation on the cloud as one that’s on the nice list (www.noshchartingsystem.com)…there’s no charge to export all your EHR data as either a PDF printout or in C-CDA format, and you can even export the entire database in .sql format. Even if you cancel your subscription, you’ll still have access to the data (just the admin privilege is active) so you can export it at any time in the case if the new system you’re transitioning to flakes out. NOSH ChartingSystem was my response to my experience as a solo doc and the unfair business practices that EHR’s were using that affected my practice. It’s about time that physicians have more options and a say in how EHR’s are designed and used and who really should own the data.

  • Definitely start a list. One of the good things about Centricity (and I can think of only a few good things to say in the 2.5 years I’ve been at a Centricity EMR) is that I have 100% access to the raw data. If we were to switch to another EMR that gave us that type of access it would take only a few months to map the data, transfer, and test. And that is only if they did not already have it mapped out. We’ve customized and created many new terms and would still have to map out these observations.

  • Surely the EHR subscribers who get themselves into such situations have heard of “caveat emptor” – the time to get things right is when you sign up.

    a) the system has a data export facility that the customer can access at any time of the day/night (pass, if it does not)

    b) the data “belongs” to the customer (clinic/hospital) [we know it sctually belongs to the patient, but the EHR hosting organization as a service provider to the clinic/hospital cannot acquire more rights than the clinic/hospital has.

    c) . . . .

  • Great idea — but you have to get both sides of the story, which will take time. Are you willing to do that?

    That said, not only should you reveal behavior, but also costs — it WILL cost a bundle to switch, due to programming differences. For example, EMRs on SQL servers have different tables, with different information that flows to different tables. Talk about complicated.

  • @Sue Ann.

    I don’t want to diminish the complications but a generic Data Exchanger with one-time programming of parsers and formatters (taking exported data and importing this to the data exchanger, reading data from the data exchanger and formatting it for easy import to the new system) helps a lot.

    The sender can use native data element names, the receiver can use native data element names, the only thing to watch out for is a 50 character input that needs to be stored in a space that only accommodates 30 characters.

    We processed 1,800,000 records a number of years ago to get data out of a mainframe db to SQL server. More recently we consolidated 214,000,000 records from a group of healthcare organizations using different software systems.

    We did another job where the source system was locked down (on purpose) we figued) such that nothing could be exported. We printed out all of the possible reports to pdf files, then used a product like Omnipage ultimate to convert to text.

    Our advice to clients is if they get mad enough with the service they are using there is a way to transition.

  • I am particularly interested in how I can hire this guy from Comcast’s Customer Retention Department. This guy really does not take no for an answer. I can’t imagine why this guy isn’t in sales!!

  • Sue Ann,
    That is the challenge. Spending enough time to really know the good and the bad. I think that it’s safe to say that every EHR vendor is on the naughty and the nice list. The key will be finding the right information (naughty or nice). To do so, you really shouldn’t label something as naughty or nice, but let the consumer decide. However, for marketing it’s much better to say it’s the naughty and nice list.

    EHR data conversion is a pain, but is possible if you have enough desire to do so (and they don’t hold you hostage).

    Mike, very true…depending on what you’re selling.

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