How a practice becomes a hostage to its EMR

When an ENT doctor wants to buy an EMR, electronic medical record, they usually check with their colleagues in the world of Otolaryngology. This practice makes sense, to an extent. But how many purchases or decisions that you make stick with you for most of your life? And how many of those did you make without testing and trying for yourself?

Put it another way, would you buy a $50,000 car without driving it first? Would you buy it just on a recommendation? Would you buy it based solely on what it looks like in the show room or because you saw someone drive it down the street?

Most software companies offer a free version or a trial version to see if it meets your needs. EMR companies generally do not. They have valid reasons for these restrictions, but surely they can figure out a way to make things happen.

My gut tells me that EMR companies are generally afraid. Its fairly well known that many practices who launch an EMR project will abort or end up using limited aspects of the EMR. Sometimes a great implementation falls short because the users figure out that the program doesn’t quite satisfy their needs. I would like to see an EMR company be bold. Is there an EMR company that is confident enough in their product that they would let a practice try it for free for a span of several weeks?

There are some who say that playing it safe would be to buy an EMR from the biggest company. Big does not make it better. A few urology groups I know have gone several BIG EMR vendors. Each of these vendors talked about how many urologists are using their products. So these urology groups signed up and spent a fortune. After implementation, they wanted to add some features that were common to the practice of urology. The EMR vendors patted them on the back and said here they are for an extra $30,000 (and for a larger urology group $100,000).
Once you have put in a lot of time and money, the BIG vendors can sometimes hold you hostage.
Ok. Anyone can hold you hostage. A small fry EMR company can custom make an ooberEMR that works so well…except that it doesn’t interface with anything. Or the 1 programmer that built the whole thing gets burned out and switches career paths.

Its not only the EMR companies that hold you hostage. Once you have an EMR, your employees suddenly become more valuable. If one of them quits, it takes time and money to get the next employee trained. Doctors who have become very dependent on their few employees have acquiesced to cost of living adjustments. Now several years into an EMR practice, the employees are making 30% more than what they made before. All the return on investment goes POOF!