Beware of Wolves in Sheep’s Clothing – Are you ready to be fleeced?

We live in interesting times.

On the one hand there are financial incentives for adopting EHRs and making meaningful use of these, but meaningful use criteria are not yet well defined. Then, there are various important studies such as the European Commission EHR Impact study that demonstrate that the ROI on an EHR takes a long time, so no wonder agencies are sitting on the sidelines.

Meanwhile, you may have been approached by most of the 300+ vendors in this space, all of whose solutions sets ‘save time and money’.

Usually, unless one is buying into Florida swampland, a buyer reasonably wants to run investment numbers through an ROI to quantify the returns. Unfortunately, you are not likely to get much out of evaluating “next generation” EHR software that really is little more, in many cases, than a rename of old Billing/Claims processing software.

What is an EHR anyway and why would I want one, you might ask?

An EHR, in the main, is a repository for patient data plus interoperability. Basically, it’s the old paper chart that has gone electronic.  Whereas you used to spend your time hunting for the Chart, it’s now readily available and you can look forward to spending your time hunting for, in some cases, 200 forms and recording data on these.  But, it does not have to be like this.

This brings me to the question “Are you ready to be fleeced?”

To be fair, if all of your patient encounters are one-on-one encounters with no real linkage between one encounter and the next and you, as the attending, are the only person who spends a lot of time with the patient, any off-the-shelf EHR might suit, but I would advise that you do the math in any case, just for future reference purposes.

On the other hand, if your best practices (administrative and clinical) include multiple steps, with complex interconnections between the steps, where different skilled resources are needed to perform different steps, then any old EHR is not going to address your needs.

Bottom line, you have, or can have, a set of ‘best practices’ that are the basis for your agency’s competitive advantage and it would seem reasonable, would it not, that you encourage your staff to follow these?

If you map out your processes, then use software to carve your maps up into steps and let the software system post ‘orders’ to the attention of staff at staff InTrays, you now have a basis for the following benefits:

  1. Increasing staff efficiency
  2. Improving patient throughput
  3. Decreasing admin/clinical errors
  4. Improving compliance with internal and external rules and regulations

Quantifying these benefits will give you a much better looking ROI, plus an expectation, over time, of improved outcomes.

I will explain these benefits in a subsequent blog.


Management consultant and process control engineer (MSc EE) with a focus on bridging the gap between operations and strategy in the areas of critical infrastructure protection, connect-the-dots law enforcement investigations, healthcare services delivery, job shop manufacturing and b2b/b2c/b2d transactions. (C) 2010-2018 Karl Walter Keirstead, P. Eng. All rights reserved. The opinions expressed here are those of the author, and are not connected with Jay-Kell Technologies Inc, Civerex Systems Inc. (Canada), Civerex Systems Inc. (USA) or CvX Productions.
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2 Responses to Beware of Wolves in Sheep’s Clothing – Are you ready to be fleeced?

  1. Wm T Oravecz says:

    Nice values clarification for someone contemplating their EHR inititative.


  2. Looks like the points made are still valid.

    A core concept to success with EHRs is 3-tier scheduling which works for healthcare and discrete manufacturing. Go figure.

    The approach is called RALB and you can read about it in a 2013 post called “Mind your Ps and Qs” at


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