The Misguided EHR Replacement Decision

This post is part of the Breakaway Thinking blog post series which is sponsored by Breakaway Learning Solutions, a Conduent Company.

Almost every healthcare organization I meet is talking about how to get better adoption of their EHR software. They’ve implemented their EHR as part of a massive go live. Many are even doing fine with programs like meaningful use and are working on MACRA. However, they all realize that adoption of their EHR software by end users could be better than it is today.

During these conversations, it’s easy to see how some organizations slip into the thinking that if they replaced their EHR with a new one that somehow that would spur more adoption and EHR use by their end users. When you hear users complaining about EHR software, it’s easy to blame the software itself. This is a dangerous line of thinking because that’s just not how it works. Switching EHR software does little to improve adoption of EHR by end users. EHR adoption problems that exist with one EHR are likely to exist in any new EHR.

That’s not to say there aren’t legitimate reasons for you to switch EHR. There are many good reasons to switch EHR software including when your organization is bought out and you want to align EHR software or when your product is being sunset. These can be good reasons to switch EHR and there are many more. However, it’s usually a mistake to switch EHR when you don’t have a good strategic reason to switch and lack of adoption is not a good strategic reason to switch.

When EHR adoption is lacking in your organization, instead of considering switching EHR, look at doubling down on your existing EHR. Core to successfully “doubling down” is leadership. Heather Haugen highlights this fundamental principle in her whitepaper “Leadership Insights: Gaining Value from Technology Investments when she says, “Organizations with leaders who are fully invested in the daily march toward adoption will reach the early stages of adoption quicker and enjoy a reinforced cycle of meaningful clinical and financial outcomes.”

The most successful organizations I’ve seen are led by people who understand that EHR adoption is not a one time event, but is an ongoing process of workflow improvement, training, and process modification. The value an EHR can provide is extracted as organizations incrementally improve their use of the EHR. It doesn’t happen by accident or by happenstance. It requires thoughtful and well executed leadership.

The idea of replacing your EHR to improve EHR adoption and use is often just an easy way out from addressing the real reasons why EHR use in your organization is not optimal. When this happens, you’re still generally faced with the same hard challenges after replacing your EHR. Don’t fall into this trap in your organization. If there’s not a strategic reason to replace your EHR software, then don’t. Take the energy you’d have spent replacing your EHR and make a deeper investment in optimizing your current EHR usage. That investment will pay off far more than an EHR switch.

Learn more about the Breakaway Thinking blog series sponsor, Breakaway Learning Solutions, and download their FREE whitepaper “Leadership Insights: Gaining Value from Technology Investments.”

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.


  • Forgot to sign this article.
    “Sincerely, Epic and Cerner”

    Dont change EHRs, just spend more money on them…Love it.
    As a CMIO that is at a large community hospital using Cerner…Cerner knows that its very costly to rip and replace, so they have little incentive to give better service, make improvements etc. Its amazing to watch. We want an integrated prescription opioid monitoring system (already paid for by the state), oh that is $15K per month. Instead of, hey the state paid for the code to be integrated, here’s an improvement for you. Simple code copy to our system. Nothing to monitor or do. Yet they want to charge $180K per year…that is ridiculous. So what are we supposed to do? Oh, yeah, pay them according to this blog article. Wrong.
    We need innovation, and we need EHR vendors/IT working every day to make improvements to the front line MDs life with tech. They are NOT doing it. They are sitting back collecting money for sub par terrible “certified” products. Its a tragedy.

  • It could be worse. Your organization could be considering a switch away from the EHR with the best adoption rate and according to Medscape the highest clinician satisfaction rate to Cerner for the low low price of $16 Billion.

  • Speaking from the perspective of small practices/clinics, I always ask providers why the want to switch and what is it that they currently have. It surprises me that knowing the product and vendor they have, these are not bad systems or companies. Majority of the times, they seem to be excuses and copouts for reasons that simply say, ‘staff does not want to change…’, even though they don’t say it in those words.

    The end result is that even after switching, going through the pain and cost of switching, they remain dis-satisfied.

  • meltoots,
    As RobertM points out, it’s not about spending more money on an EHR. It’s about not spending even more money switching EHRs. The cost to switch EHR software is a lot more than it costs to optimize your current EHR. Plus, you have to remember the principle of sunk costs when evaluating your future investments. If there were a revolutionary EHR out there that was dramatically better then switching EHR would be a great idea. Until that unicorn EHR appears, optimizing your current EHR is going to be a better investment than switching EHR for most organizations.

    You understand the issue. Switching to solve problems rarely solves the underlying problems.

  • Completely agree with your point about switching EHRs – there needs to be a strategic reason to change, as well as making sure the practice has fully adopted it before deciding its not working for them (however, sometimes it’s more of a fundamental issue of not being specialty-specific, which would be a strategic reason to change!).

    EHR adoption is an ongoing process of workflow improvement, training, and process modification and utilization. Another challenge is the fact that we as humans tend to resist change, which also makes switching solutions effectively difficult. To improve the likelihood of replacement and adoption success, a practice needs to choose a vendor that aligns with their strategy, and has the flexibility to support both their workflows and users.

    Other considerations are aligning cross functional support for change, and have a strong leader in place to direct and manage their change.

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