Switching EMR and EHR – What are the reasons behind

Switch to EHR / EMR from Paper

The transition from paper charts to Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems is very challenging and demands extensive resources and efforts. Encapsulating this switch to an EHR system, Amanda Scanlan painted a real time scenario in the article Paper-based Records to EMR: A Transition in Context. She has narrated the troubles of scanning patient records maintained on papers, converting them to digital archives and indexing them into an electronic system.

Switching EHR Vendors

It is hard to shift from a long-established paper based practice to an electronic system but it is even harder to switch from one EMR system to another, offered by a different vendor. However, it is an interesting fact that early adopters of EMR and EHR software are now switching vendors or service providers for another electronic medical system. The decision to switch from one platform of EMR and EHR to another service provider invokes almost double the pain gone through on shifting from paper-based medical system to an electronic system. It is even more complicated when you have used an XYZ electronic medical system for quite a reasonable time now and you decide to shift to another system on the pretext of wanting better capabilities. In the switching process, all your records and patients’ information is structured and indexed by the current system and if you are using a cloud based or web based EHR, you don’t know where on earth those electronic records exist, how to retrieve them and make useable with the new electronic medical system. Either you have to print them out all on papers and have to start over again or with the advice of the new service provider, all the records have to be transformed into convertible digital formats (XML, CCD etc.)

Regardless of the difficulties involved, health care service providers are switching one EMR/EHR application to another system for a few valid reasons.

  • Not satisfied with the current EMR system. Obviously dissatisfaction with the current system may lead to discard a running system. The system may not be fulfilling the requirements of the practice due to multiple reasons.
    • Poor customer service and technical support by the vendor in down times, support team cannot answer properly on calling and technical issues waste a lot of time and appear with greater frequency.
    • The EMR system is difficult to operate either because the interface is not user friendly or due to the absence of proper training.
    • The EMR system lacks specialty features and templates required because it was not customized for that specific medical specialty.
    • The design does not match the workflow of the practice and is not flexible either. It happens especially in a case when staff was not consulted in the selection process.
  • The meaningful Use program has been pronounced as one of the major reasons behind switching EMR/EHR systems. Meaningful Use is raising the bar day by day, demanding new requirements to be included as part of the electronic medical system, meeting which is required by CMS to receive incentive payments. Meaningful Use criteria require users of EHRs to demonstrate certain objectives and measures using certified technology, just as
    • Meet clinical quality measures
    • Electronic prescription capability
    • Patient interaction
    • Health information exchange meeting HIPAA requirements
    • Online access of the patients to their health information etc.

    The Meaningful Use program has promulgated a lot of software features required to meet at different levels of attestation. Meeting these indispensable requirements need a continuous upgrade in the EHR systems which is very difficult to keep pace with and health IT companies remain consistently engaged and when they do not fulfill clients’ requirements they switch to better systems.

  • The vendor is charging extraordinarily for every set of new features or up gradation. Unlike other vendors, SequelMed has been phenomenal in this regard, it charges no fee for system upgrade or does not charge later on the expenses which were kept hidden at the time of implementation.
  • There are conflicts in the integration or synchronization of the EMR software with other applications.
  • Hardware changes at the facility also lead to conflicts and users make a switch to compatible EMR software. For instance, the EMR system previously installed was designed for desktop computers and hardware upgrade to tablets required touch screen interface, in such assumed situations, EMR users opt to switch.

Sometimes EMR and EHR vendors discontinue support either because they were acquired by another company or they simply went out of the business. It is also one of the many reasons that EMR users make a switch to another vendor.