The Same EHR “Chain of Events”

I recently came across this interesting perspective on the EHR industry on the MGMA blog. Here’s one of the perspectives shared on the blog post:

Miske said his practice’s previous eight EHR selections have followed the “same chain of events”:
*Heavy research, tons of demos
*Training and research
*Relentless tweaking
*Stagnant use
*Systematic bugs reveal themselves
*Issues become unreasonable
*Tech support starts to lack

For his practice’s ninth EHR, Miske refused to settle for inferior quality or employing counterintuitive fixes, such as saying, “let’s hire more people to deal with the inadequacy of the program.”

“Being of the technological mindset that I am, this is unfathomable – the EHR/PM system needs to be a tool and a wonderful tool. Just like our ultrasound machine that allows us to perform 4D miracles without issue daily,” he says.

I have to start by addressing that the above comments are by someone who has done 8 EHR selections. Sure, that means they’ve had a lot of experience with EHR implementations, but from my experience it also likely indicates an internal issue that all 300 EHR vendors would likely face with that practice.

I was recently talking to an EHR implementation manager at an EHR company. They recounted to me how their sales people would bring them a new sale and comment that “this EHR implementation should be easy since they’ve already had 3 EHRs previously.” He then commented that those always end up being the worst implementations since there’s likely some organization problem that needs to be fixed before doing the EHR implementation. Certainly having some understanding of how EHR and software work helps during an EHR implementation, but so many failed EHR implementations often means that something else is at play beyond the EHR.

Personally, I haven’t seen the chain of events that he describes. I’ve seen certain pieces of what he describes, but not all EHR implementations follow that pattern. The last 3 items on the list are things I’ve seen a lot of places with a bunch of EHR vendors.

Bugs are a reality of software use. The key is how the EHR vendor reacts to your bug reports. That will make all the difference in your organization. This is why I’ve said many times that you should cultivate a close connection to your EHR vendor. When you find and report these bugs, having a good relationship with your EHR vendor will be critical to make sure your report is heard.

In the beginning of your EHR implementation, you’re likely to get special attention. So, take the time early to really figure out any pain points the software is causing you. You’ll likely get a quick response. As you become a long time user, you’ll have to rely on a deeper relationship.

If all else fails, remember that the squeaky wheel gets greased. Be careful not to ruin your relationship, but there are a lot of ways to get your concerns heard and addressed. Don’t be shy if a change really matters to you and your organization.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, 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,, 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.