Mar 22nd, 2009 by Laura Who Should Conform: You or the EMR?
So you’ve chosen your EMR and now you’re heading down the implementation road and you come to a fork in the road: one way is to go with the EMR vendor provided workflow and the other is to forge your own path. I am lucky that I have been witness to physician organizations traveling down each path and some jumping between the paths because they can’t seem to make up their minds, so I will try to weigh the pros and cons of each.
Traveling the EMR Vendor Workflow Path
Pros
- It has been tested and is being used in many practices around the country.
- Your vendor should be able to provide you with reference practices if you have questions.
- It is often much more affordable.
- If the vendor upgrades their workflow to be more efficient or to meet new standards, you should be easily upgradable.
- Your vendor should be able to provide you with training materials for your staff.
- Your implementation time should be much shorter.
- The EMR vendor typically has more resources available to it than your practice will.
Cons
- Sometimes there are problems with the workflow and you may be able to make it better, you have to make the choice to stay on the path or deviate from it.
- If you are a specialty your vendor hasn’t implemented yet, you have no choice but to create your own.
- You may not agree with the workflow they have created or it may not work exactly the way your practice works.
Traveling Your Own Path
Pros
- You have the power to make the EMR exactly the way you want it.
- With enough time and investment, you can make it sing in perfect harmony with your practice better than an EMR vendor’s standard workflow could.
- You wouldn’t have to see things you didn’t do and would have everything at your fingertips that you did do.
Cons
- Just because your workflow works with paper, doesn’t mean it translates to an electronic workflow.
- You are on your own if you have any questions.
- It can become extraordinarily expensive.
- You have to build your own training material.
- Typically you aren’t as upgradable as you would be if you were on the EMR vendor’s path.
Personally, I’m a fan of a hybrid path and try to do this when I work on implementations. Of course, it’s the clients choice at the end of the day but it’s what I typically recommend. It definitely depends on what type of budget and timeline the practice is looking at. I’d love to hear stories of the path people have decided to take.
March 23rd, 2009 at 8:02 am
We are having a problem with the PAQ because we are a family planning organization staffed with Nurse Practitioners that float to 29 clinics. Some of the NPs may work one day a week, some never in the same clinic in a month, etc. So our issue is that we would like to have a location que so that the NP following can handle the patient’s labs and other issues related to that clinic. We have even considered assigning someone else to handle each others ques, but then they must wade through a tremendous amount of various clinics labs to find the ones they are assigned to handle that day. I would love to hear of any solutions from someone in a similar organization. NextGen has been unable to come up with a solution.
March 23rd, 2009 at 8:05 am
Thanks
March 24th, 2009 at 5:18 pm
[...] Who Should Conform: You Or Your EMR? encapsulates in one pithy question, the essential nature of the IT dilemma at the provider level. [...]
March 24th, 2009 at 9:03 pm
Liz-
I definitely think this is a very tricky situation. Are you on 5.4 or 5.5? Are your NPs ordering labs or only your MDs? I think in some respect you’re going to have to bend a little to what NextGen offers. If you have some time, I can try to help but NextGen only takes you so far with the PAQ and multi-location/floating nurses.
April 2nd, 2009 at 3:27 pm
I’ve always seen an office end at a hybrid path. In fact, I’ve never seen one take completely the EHR suggested workflow. However, EHR companies build most of their software so that you can modify the workflow, because they understand each clinic is different. Each EHR has different levels of customization though.
One clinic I had started with their own workflow (as much as possible), but within a year after migrated to a hybrid workflow. Was the best move they ever did to move to the Hybrid.