Change EHRs? I’ Been Busy
No matter what, if you’re a practicing physician, you can honestly state – at any given moment in time – “I’ been busy.”
Whether it’s actually providing patient care (a much smaller percentage of your work day than ever) or attending to administrative chores (a MUCH larger chunk of your day now) or messing around learning about silly stuff like advances in medicine and healthcare, your day is never one of “oh, not much, what are you doing?” Is it any surprise then that physicians are reluctant to make changes to the digital tools they employ?
Sure, there’s a lot of hubbub about EHR swaps and disgruntlement with first-choice systems. Docs and CIO-types are finding that all their so-called “due diligence” has yielded a system that met Meaningful Use requirements sufficiently to obtain MU dough, but that are oh-so-woefully lacking when it comes to meaningful day-to-day use. Disgruntled docs are dutifully documenting their discouragement with difficult data entry devices and systems on blogs and other fun physician forums. But change EHRs? EHR swaps are not for the faint of heart … nor for the busy.
Sure, if you’ve got nothing better to do, you can spend even more time looking even more deeply into even more EHRs and EMRs than you spent the last time (during your scurry to access MU opportunities and dollars). You can do the demo dance with vendors, dialogue with other docs about their documentation dilemmas, and dig down into digital details that you never really cared about from the get go.
You can ask about data migration. (Good luck on that one!) You can ask about data ownership. (Better read the fine print.) You can listen to the extolled virtues of “cloud-iness” versus local hosting. (Remember to calculate support costs.) You can even find some vendors that will let you use their system for a time without ponying up any payment. (Playing around with fake patients to explore an EHR system – what could sound like more fun in all your spare moments?)
Of course, if you’ve been “institutionalized” or otherwise absorbed by some medical Borgian amalgam, you may not have much say in your EHR choice. Your next system may be thrust upon you just as unceremoniously as was the first. You might, then, even count yourself lucky on this since you don’t have to worry about all the new system search suffering. (You just have to suffer its actual implementation and use.)
But, if you’re still independent or part of a smaller group, or if you’re in charge of seeking out a new, better system for a larger group AND you still actually see patients on a fairly full-time basis, you know how easy it is to just keep using a clunky system. Even an EHR that does documentation with all the simplicity and ease of Fred Flintstone’s flint rock tablet is better than the angst and anguish of change.
There are better systems out there, to be sure. There are EHRs and EMRs that actually make documenting easier. (Honest! Really. It’s true.) But the problem is that finding them, and finding the one that’s right for you and/or your group is about as time-consuming as looking for a new case of smallpox, maybe more so (and perhaps just as fruitful). And then there’s the whole workflow and business processes change thing. Oy.
Poor systems and workflows that may not be the most efficient are nevertheless paying your bills and getting you home sometime before last call (usually). Searching for and living through the transition to your next EHR surely threatens your current homeostasis, even if the potential for improvement – after all is said and done – is real.
It’s tough to think about going through all those process changes again … especially when it’s so true, and so much easier to say, “I’ been busy.”
From the trenches…
“In the choice between changing one’s mind and proving there’s no need to do so, most people get busy on the proof.” – John Kenneth Galbraith
Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership.