Is there a best EHR system? Perhaps Cerner, Epic, GE, or McKesson? For those who have followed my writing, you’re probably thinking my answer is “None of the above.” I’ll do one better, and I write this with the utmost sincerity—it does not really matter which vendor you select. As the EHR vendors reading this pull themselves off the floor, permit me to explain why.
Researching the question, I’ve found very little information to support the notion that any of the major hospital EHR systems quantitatively stand out from the others.
There are a few sites that offer user assessments across a range of functions, but those have at most three opinions—not enough to consider statically significant. There are plenty of EHR scorecards and comparison tools, just not many scores. The vendors’ sites do a poor job of differentiating themselves from their competitors. Vendors use superlatives and qualifiers in an attempt to differentiate themselves, but no vendor highlights major clinical or business problems that their solution solves which another vendor does not.
The only information I found that might be worth a read comes from KLAS Research, http://www.klasresearch.com/. However, the names of the modules rated are vendor specific, and none of the vendors use the same names. It will give you a feel for how a feature rates within a given vendor, but there is no data to suggest how those ratings compare among vendors.
If this is a fair assessment, what accounts for the difference? How can we account for why one hospital loves a given EHR system and another one hates the same system? Chances are they both needed about the same solution. Chances are they received about the same solution.
Here’s the difference. The hospital who thinks they made a good choice:
- Had a detailed strategy and implementation plan
- Paid as much or more attention to process alignment, change management, and training as they did to the implementation
- Managed the vendor instead of being managed by the vendor.
Simply put—the problem is not the EHR system.
One other thought. Do not put your scarce capital into a solution just because it offers or promises either Certification or Meaningful Use. Yes, there is much discussion about both of these. The industry stops and holds its collective breath each time a new set of stone tablets are brought forth from the ONC or CMS. You can meet Meaningful Use with a Certified system and still wind up with a system the users hate and that does not support your business model.
Here is something else I cannot explain. For those hospitals replacing $100 million EHR with another $100 million EHR, why do they think the second system will be any better? If the systems are not materially different, the only way to get a different result is by changing behavior, not changing systems. Why make the same mistake twice? What could be so wrong with the first implementation that an expenditure of far less than another $100 million could not solve?
What is the cost of EHR 2.0 not working? I’ll let you know as soon as I see an organization going for the trifecta.