Some Advice for Buying an EMR/EHR

Here at Liticodec, we don’t practice medicine, but we do practice technology and electronic records and have been doing so for a very long time. Since well before the current trend of faster/cheaper became fashionable, and because of that, we’ve learned a few tricks about the system acquisition (purchasing) cycle that you might not think about, but can probably benefit from.

Do your purchasing according to tried and true practices of defining criteria and doing vendor selection. An EMR is not a trivial item, it is foundational and will make or break your healthcare practice. Involve the right people. If none of that makes sense, HIRE SOMEONE who understands purchasing principal systems and don’t rely on the advice of someone internally just because you think they know what they’re talking about. You want to make sure EVERYONE is backstopped by a proper value based decision with defined and trusted characteristics.

Defining those characteristics can be part of the problem, along with relying on vendors to be truthful in their descriptions of what their systems do. There’s a quick and dirty way to figure out if a particular system suits your organization, and that is to go and do site visits. Select a cross-discipline team of physicians and nurses and IT and send them to other installations for several days to shadow people and dig into the real operations of the system being reviewed. Dig deep. Look at the user interface in action. Look at the interfacing and reporting. Look at the errors and support needs. Look at the BC/DR capabilities.

Yes, this will cost you a lot of money, probably upwards of $100,000 for looking at 3 different systems. If it saves you making a $3M purchasing mistake, it’s money well spent. If you’re REALLY good at purchasing, you can get the vendors to pay for the excursions so you don’t have to. That’s the best way, because if the vendors don’t have that level of faith in their system or that level of funding for sales, then they probably aren’t a good choice. Remember, a mistake in purchasing an EMR goes way beyond the price on the invoice, so you have got to get it right. The more right it is, the better you all look on the cover of the monthly healthcare magazine. The more wrong it is, well, we call those “resume generating events”.

Please make sure to include security and forensics in the criteria. That’s our part. We’re available to assist with purchasing evaluations if you need us, and we only need one day and it doesn’t even need to be on site. We can also help with the business side of things, if you’re light on the IT side as some organizations are. Proper purchasing processes and vendor evaluations were figured out back in the 1960’s so there’s no reason for anyone to get it wrong.

Purchasing and Metrics as Key Business Indicators

It cannot be overstated enough that the two most powerful weapons in a company’s policy arsenal are proper purchasing protections and performance metrics.

Without smart purchasing, businesses tend to waste money on solutions that are inadequate and penalize the company repeatedly until cured. The money needs to be reallocated to purchase the correct solution, and while it is in place, the company fails to gain any advantage from the wrong solution; possibly loses ground.

Proper metrics are what allows a company insight into layers of operational intelligence. Without good metrics that permit comparison with competition and external industry measurements, perceptions can be flawed and gains lost. Worse, improper use of metrics can lead to stagnant areas of insight which undermine the entire purpose.

These two areas are clear marks of maturity in a business and keys to remaining competitive and obtaining market dominance. But they are HARD to do. So we see the almost nowhere. This despite the fact that both areas have been understood and well defined for 50 years!

Now, the interesting thing to us here at Liticode is the ramifications these two key indicators have on information security and litigation costs.  Because the cost of a failed security tool purchase are potentially far greater than the cost of the mistake and the fix.  If there is an event stemming from the failure in purchasing, it can have catastrophic consequences well in excess of the purchase costs.  All stemming from a failed purchasing policy.