I’d recently heard a practice manager talking about their EHR and Practice Management system. We talked about the EHR they’d selected and what they thought of the setup, and then I asked which practice management (PM) system they were using. They responded that they’d been using the same PM system for so long, they didn’t have any desire to change it. Then they dropped the bomb:
“There are a lot of things we hate about our PM system, but we kind of look at it as the devil we know.”
I see this happen really often when it comes to EHR and PM systems. In fact, it happens everywhere in the world of technology. Sometimes we don’t have any desire to change because we know the system we have and it works. Does it have its pain points? Yes. Do they drive us nuts? Yes! But at least we know about them and know how to deal with them.
There’s a real fear by many to switch to a new software where they have to learn about new “devils” for which they don’t know how to handle. I’m often reminded of the concept that “change isn’t always better.” So, in many situations, it’s better to not change. Maybe what you have isn’t very good, but if you’re not careful you could change to something even worse. That’s a real healthy fear.
That said, the fear can go too far. I’m reminded of when I had my first Android phone. I’d gone pretty cheap and gotten this really inexpensive phone. It worked, but was really slow. Plus, the battery barely lasted and it had plenty of devils I had to deal with whenever I used it. Luckily, I didn’t use it that much since I mostly work from home. However, when I was stuck in the depths of a massive exhibit hall at HIMSS and couldn’t get connectivity or I was waiting on the phone to do something, it was absolutely annoying.
The devils of that phone finally got to me and I upgraded to the Samsung S3. It was night and day difference. I must admit that I really didn’t know what I was missing. In many ways that was good, because it helped me to appreciate the upgrade. However, I’d kind of gotten complacent and was fine dealing with the “devils” I knew. (Side Note: Thanks to a few cracked screens from my wife and children, I’m now on the Samsung S5 and it’s awesome. The battery life itself is so compelling.)
Unfortunately, there’s no science to when to stick with the devils you know and when to upgrade. Without incentives, penalties or other regulations, there’s almost never a financial justification to upgrade software. It’s almost always cheaper to limp along with the old technology. However, there’s an extremely important sanity portion of the upgrade decision that is key.
I’ve personally found the time to upgrade and switch is when you know that the upgrade will solve the “sanity” issues you’re experiencing. If the upgrade won’t solve those issues, then it’s better to stick with the devil you know.
There are some excellent companies that provide “at the elbow” support for EHRs. OR, we have seen (in the case of a Community Connect client) where a group of experienced users have stepped in to offer support for a few weeks at the start. But I completely agree with the fear of change. I still have my old iPhone and won’t change till it blows up.
John,
Your point is spot on in your example. To take it a step further, I too had a AT&T Brick then eventually Samsung Flip Top. I then upgraded to the S3 and it was great, it also came with a free mobile internet USB connection to tether (WORD DID NOT EXIST AT THAT POINT) or in other words treat like a Modem. Then I got the S3, it was awesome, and I found FoxFi a free internet access to Tether since the new phone required a data plan cost to use it as a tether device. Then I got the S5 and at first it was not available to use FoxFi, it was purposely disabled by the vendor Sprint, therefore, I had to wait until the FCC forced sprint to not regulate this item.
My point is as follows: Like the S5 change, a change in the PMS could cripple even the most basic of features, like Billing Services Required via certain clearing houses or Patient Registration processes that are at best, slowing end users down, and at worst crippling them. Don’t even start with Schedulers, because some of these truly are great and some are to be kind, lacking. If like the S5 the PMS causes you to use a certain procedure or service to work, then it could be way worse then the old Dog (like Medical Manager) that is tried and true and all the users know how to use it.