Switching EHRs is expensive—but physicians find plenty of reasons to change vendors
Physicians, hospitals and health systems cited a variety of reasons for looking for a new electronic health record (EHR) vendor, from seeking better functionality to meeting new regulatory requirements. The fact the change likely won’t bring a quick return on their investment, however, doesn’t seem to deter anyone looking to make a switch.
In the spring 2018 issues of Perspectives in Health Information Management, researchers reviewed 26 existing articles to come up with qualitative analysis of why systems and physicians want to switch vendors. Led by Alberto Coustasse, DrPH, MD, MBA, MPH, professor of healthcare administration at Marshall University, the study found various explanations, including “inefficient workflows, lack of reporting capabilities, mergers and acquisitions with larger health systems requiring more complex systems with greater interoperability, and the need to interface with other systems.”
A 2013 survey from the American College of Physicians found 34 percent of providers were dissatisfied with their current EHR’s ability to decrease workload and 37 percent were unhappy with the ease of using it. An equal 37 percent said they wouldn’t get the same system again. A 2014 survey conducted by Verdon found even higher levels of frustration, with 73 percent saying they wouldn’t purchase their current system.
Dissatisfaction would understandably lead to systems considering moving to a new system but switching EHRs is no easy proposition from an operational or financial perspective. High cost was the “most obvious negative outcome” from changing vendors and the biggest barrier to adoption, the study said, with one survey it referenced finding two-thirds of respondents reported losses due to implementing a new system and almost half believing the new EHR’s cost was unjustified.
“This finding helps to illustrate some of the frustration with switching to a new EHR: if a health system does not believe that the cost is worth incurring or believes that the system will not receive a return on the investment, providers are less likely to get on board with switching to a new EHR, even if it would provide easier or better patient care,” Coustasse and his coauthors wrote.
There were also no guarantee providers would be happier. In one survey of physicians practicing in ambulatory clinics that had transitioned to a new EHR, 47 percent said they were somewhat or very satisfied with the implementation of the new system—but 40 percent said they were somewhat or very dissatisfied.
Physicians and leaders who had undergone an EHR transition recommended planning ahead for this kind of dissatisfaction can make the change go more smoothly. Their suggestions included managing expectations, providing lots of training, being honest about problems and having a cash reserve to cover lost operational costs during the transition.
The authors concluded that while providers may not believe the cost of switching EHRs is worth it, the push to improve workflows and achieve greater functionality—especially interoperability—may outweigh those financial concerns in the end.
“Switching has proven to be a costly endeavor, but in view of the lack of value provided by their former EHR systems, many healthcare systems have chosen to move forward with switching vendors despite the possibility of not receiving an immediate return on the investment,” Coustasse and his coauthors wrote. “Each health system will need to do a full evaluation of their current state and desired end state to determine if switching vendors is advantageous.”
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.