In the comments of my post “EHR Replacement Roadmap to Success“, John Brewer provided a great reminder that changing EHR software doesn’t always mean that you’ll change to a better EHR. You might change to something worse. At least that’s my summary of his comments. You can read his full comment if you want.
I’ve learned this lesson over and over in my career. Sometimes you need to be content with what you have. One example of this was when I was working at a University in Hawaii. I was quite disappointed with the CIO and thought that he could do a lot of things different. Well, I got my wish and the CIO was replaced with someone else. Considering the topic of this blog post, you can imagine what happened next. The replacement CIO was so much worse than the previous CIO. Lesson learned.
Change doesn’t always mean a change for the better. It can certainly mean a change for the worse.
This applies fully to EHR replacement, which is quickly becoming a hot topic as many people regret their EHR purchase decision. You do need to be careful that you’re so afraid of change that you never change. In many situations change is the right decision. Plus, unlike my story where I had little control over who was hired as the new CIO, when you switch EHR software you can have some impact on the selection and end results. In many cases, you might even discover that you shouldn’t switch EHR before it’s too late.
I expect most people who think they need to switch EHR need to be careful to not set a predetermined course early in the process. Instead of saying, “Which EHR should I switch to?” I believe that many should dig deeper into the question, “If I switched EHR software, what would improve?”
As I replied to John Brewer in the post linked above, it is often (but not always) the case that the second EHR selected goes better than the first. I’ve found that the first “failed” EHR implementation usually teaches some great (albeit costly) lessons that they’re able to avoid the second time around. However, there is a tendency the second time around to focus too much on the first EHR issues that can cause different trouble the second time around. As in most things, there’s a balance to be had.
My best suggestion is to not do anything too impulsive. Let the idea sit and germinate a little before you do anything too drastic. Emotional decisions with EHR software selection (and quite frankly many other decisions) often leads to bad outcomes.
Painful as it might be, I think the best course of action for those who want to switch is to do a thorough requirements analysis. It’s likely that their original decision did not involve this leading to the quandary they are in now. Obviously, other factors may be at play as well, but their dissatisfaction might stem from one or two particular problems, when several might be at play.
Requirements analyses take time and and resources, but the alternative is having to change yet again for failure to meet needs.
I would preface the questions “Which EHR should I switch to?” I believe that many should dig deeper into the question, “If I switched EHR software, what would improve?”
with
“What are my needs?”
In order for this to work the Agency has to have in place a set of goals/objectives e.g. improve staff efficiency, improve throughput, decrease errors, improve compliance, hopefully with some quantification for each of these.
Picking an EHR is far down the path of
mission->goals/objectives->EHR contribution to these goals/objectives ->EHR shopping ->EHR selection.
The absolute wrong approach is to make a comparison of features/functions.
More usually is not better.
Great additional commentary Karl. I agree. Understanding what would improve requires that you understand your needs.