- Dissatisfaction with current EHR systems, inefficient workflows, and the need for greater interoperability and functionality are often key reasons why healthcare organizations may opt for an EHR replacement, according to a literature review published in AHIMA’s Perspectives in Health Information Management.
Entities are also likely to push forward with plans to switch EHR systems even if they may not receive an immediate return on investment, wrote Coustasse, et al. It can be expensive to opt for an EHR replacement, but a lack of value in current systems will also help push organizations toward finding another option.
“The cost of switching systems can seem excessive, often in the millions, when the cost of the new system is coupled with the cost of its implementation; however, health systems must remember that the benefit to the patient is the main priority,” report authors explained. “Some practices have found that the functionality of the new system increases the level of care the patients receive by speeding up communication.”
Citing data from the American College of Physicians, the research team reported that 34 percent of providers were dissatisfied with the EHR’s ability to decrease workload, while 32 percent had not returned to their normal productivity two years after implementing an EHR system.
Additionally, a study originally published in Medical Economics revealed that 65 percent of respondents reported financial losses because of their EHR system implementation. Thirty-eight percent of those surveyed also had doubts that their current system would be viable within five years. Approximately three-quarters of respondents added that they thought their EHR vendor would still be in business after five years.
However, another survey found that 64 percent of providers who had transitioned from one system to another were more satisfied with their new EHR system. Coustasse and fellow researchers noted that physician age could also impact EHR use, “meaning that younger practitioners experienced more satisfaction with the EHR.
“Different strategies and challenges arose in regard to switching EHRs,” the report stated. “Physician resistance, training, and protection of patient information continue to be issues in EHR implementation, whether a practice is switching to a new EHR system or implementing one for the first time. Providers will need to plan accordingly in order to manage these issues when switching.”
An increase in EHR company mergers and acquisitions can also have an effect on the EHR replacement process, report authors explained. Depending on how an acquisition occurred, “healthcare professionals may run the risk of being unable to retrieve data, experiencing a stop in customer support, or even facing higher prices.”
Authors pointed out that health systems vary in size and implementation strategies, which can make it difficult to truly compare cost and complexity between different health systems’ EHR replacement processes.
“There was a significant lack of data specifically regarding switching EHRs as opposed to the first implementation of an EHR in a healthcare setting,” the review noted. “Future research should examine the results attributable to switching EHR vendors.”
Overall though, the cost of switching EHR systems is the largest implication for US providers, the authors maintained. Software and hardware upgrades, repeat staff training, and unfamiliarity with a new system will likely occur as organizations switch over from legacy systems.
“The incentive monies are not high enough to cover the expense, and as a result the cost of care may rise,” the authors wrote. “In order to meet the data-sharing requirements and other requirements still being defined by CMS, provisions of $44,000 per eligible health provider, paid out in stages, were established and may be paid out upon successfully meeting the requirements of the legislation.”
Additionally, patients may be faced with higher copayments and higher premiums because of those increases in costs.
However, the nationwide push for improved healthcare interoperability can be fueled by the increase in EHR implementations.
“Even though numerous EHRs are available, the market has matured enough for a few big names to rise to the top,” report authors explained. “With more health systems switching to some of the more widely utilized EHRs, the interoperability issues of the past may be easier to overcome with more interfaces being built and potentially with the new FHIR (Fast Healthcare Interoperability Resources) standards being implemented by the vendors.”
Switching EHR vendors can be costly for healthcare organizations of all sizes but there are definite benefits in having an updated system that aids in patient care.
Ensuring communication with clinicians through the entire replacement process, implementing comprehensive and regular employee training, and finding a system that meets an organizations needs can help with a potential EHR replacement.