In the last week’s post on optimization, I made the case that hospitals should consider optimizing their current Electronic Medical Record (EMR) system instead of implementing a replacement. Since then, I’ve had three different people approach me and ask about this. The question I’ve heard is, “Are there still times when you would replace a system?”

The answer to that question is yes, absolutely. In the case where the current system, even when fully optimized wouldn’t be a good fit for your operating environment, replacement — as soon as possible — is a sensible strategy.

Situations Where a New EMR Makes Sense

Complexity: I recently worked with a hospital that is unsatisfied with their EMR. They’ve found that it’s difficult to maintain with their current level of expertise, and that their overall expertise isn’t something they can afford to expand due to their small size. The costs of both maintaining and performing critical upgrades, such as those required for Meaningful Use / MIPS and ICD-10 far exceed their expectations. There is no question that an optimization would make the EMR work better, but the product would still be a poor fit for their operating environment. For them, a change of EMR platforms is worth considering.

Incompatibility: Another recent client is unhappy with the level of integration they’ve been able to achieve. Their product is proprietary about allowing interfaced connections, with almost every interface connection costing $25,000 – $50,000 from the EMR side, and those interfaces are inflexible in their implementations.

The quality of integration is actually quite significant. The current expectations of a modern billing and EMR system requires serious integration to function effectively. A best of breed IT strategy simply isn’t practical in today’s environment. The EMR serves as the hub for the integration in most cases. If your EMR doesn’t fit well in that role with your existing clinical systems, a change may be the best solution.

Extinction: Finally, consider what might happen if there are major strategic shifts in your vendors. If your systems vendor decides to sunset your EMR, you have no choice but to replace it. Another reason would be changes in the marketplace — Cerner’s recent acquisition of Siemens Health care raises questions about how the Siemens Sorian and Cerner Millennium products will be supported or integrated. As those integration decisions are announced to customers, some hospitals will undoubtedly find that their previous strategic direction is no longer possible or sensible. In those cases, a rapid effort to develop and implement an appropriate tactical plan to replace the affected product(s) is in order.

What These Reasons Have In Common

It’s important to note that all of these examples are about business/IT strategy. When the current product doesn’t, cant, or won’t meet the long term needs of the organization,  system replacement can make good business sense. As we discussed in the previous post, replacement is not usually a good value-add strategy to deal with end-user complaints about usability. Unless those complaints are truly rooted in the usability of a product that just can’t meet organizational needs, a system optimization strategy is almost always a better value for the hospital than a new system implementation.

The decision to optimize or replace an EMR can be a complex one, and has significant financial and operational ramifications. Phoenix consultants are experienced in all major EMR platforms, and can guide you in making this critical decision. Let us know if you need help with your systems optimization or replacement.