Are you a member of the healthcare “revolving door” community?

Take a moment to think back over the past 10 years and count the number of EMRs you have acquired over this time frame.

If the count exceeds two you may be a member of a “revolving door” community where an organization acquires software, tries it out, discovers that it is lacking in one or more ways and then goes back into the market for replacement software. Some of the organizations leaving one system move to systems that are being abandoned by others.

If you are part of this community, you are not alone.

The LinkedIN discussion called “Top Ten reasons why EMR/EHR implementations are failing” started by Ramkumar Kashyap in 2009, had, at the time of publication of this blog post, 2,806 comments and counting.

Why do EMRs/EHRs fail?

First of all, it’s not entirely the government’s fault – whereas financial incentives have set a focus on software capabilities where clinic/hospital efficiency is not mainsteam, the MU certified products, for the most part, are the same products that existed before the MU legislation kicked in.  Only you can determine the ROI for any product you choose.

Mostly, it’s the fault of the vendors . . .

The bottom line is that one-size-fits-all “solutions” end up suiting no one, so your first cut in the selection of an EMR should be to set a focus on a proposed solution that lets YOU manage YOUR workflows.  Most of what you see on the market are one-size-fits-all “solutions”.

But, some of the fault is yours  . . .

Do not opt for a “solution” that requires that you change the way you manage your day-to-day operations.   You and your organization have spent years developing policies and procedures that give your organization its’ competitive advantage.

Beware of products the vendor says will “accommodate” your workflows. These products won’t.

And, be wary of offers by the vendor to “help you customize” their system.  Customized solutions involve costly programming and are difficult and expensive to maintain.

The right solution is the one that lets YOU document your best practices and own and manage these.

A simple way to assess the extent to which you will be able to own and manage your best practices is to tell the vendor you want a web demo where you will build and piano-play a small best practice that is representative of agency policy/procedure.

Tell the vendor you will be sending images of the forms you currently use within your agency and that you would like to schedule the demo for tomorrow. Time things so that the form images arrive no earlier than 24 hours before the scheduled demo.

If the vendor cannot accommodate your request, chances are the system does not have the adaptability you should be looking for.


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, major crimes case management, healthcare services delivery, and b2b/b2c/b2d transactions. (C) 2010-2019 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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