Fear and Risk of EMR Implementation

This is another story of a conversation I had yesterday with a two provider clinic that is considering a web-based EMR (Cloud EMR or SaaS EMR, whatever you want to call it).
The Providers are all excited, gung-ho about getting started. They’ve done their homework. Started off with an on-site demonstration, talked to some of vendor’s clients in detail, probing them with everything from ‘are you happy’ down to the nitty gritty. They even visited the Vendor company to get a feel for who’s behind the company, talked to the CEO as well as their support and training personnel. Finally sat down to negotiate price.

Oh by the way, they did the right thing. Initially, they did not ask, ‘how much’? They wanted to know if the solution was within their range and affordable, rather than asking for a full quote upfront. That’s the way it should be. You are not buying candy or commodity. This is a complex solution that will change the way a Medical Practice does business for ever. How can you just buy on price? If so, why not just have ‘shopping carts’ for EMR – one of this and one of that? Pardon my anger and frustration, but some providers just don’t get it.

Anyway, I digress…

In a casual conversation with their staff, initially no one spoke in front of one of the owner providers. Someone casually mentioned – ‘Dr. is excited, I’m not sure about us’. That broke the ice.

We had a very candid conversation to bring out what the fear really was about. Everyone had their concerns, and as I listened, it became clear that this is not unusual at all. I think this kind of fear exists everywhere, it is just that most people don’t express it. Here’s what I heard in a nutshell –

  •  Biller – I’m just afraid about the entire migration. Will something get dropped in the process? I will have to work with two systems in parallel for a long time, I don’t know how long… when do I know when to transition entirely?
  • Office Administrator – What do I do with paper charts? Doc is not very tech saavy, I am afraid this will just create chaos. Something will be on paper, some on the computer, and will we scramble to find what is where?
  • Front desk and other staff – Just the usual fear of unknown.

It was interesting that at the end of the meeting, everyone was looking forward to going electronic.


It is always the fear of unknown. Bringing out the issues and fears in the open, addressing them head on, is half the battle won.

The key is for all Practices, their EHR / EMR champions to hold such meetings and bring out issues in the open. Hold these meeting with vendors, consultants so that it does not appear one-sided.

It is extremely crucial to have a complete buy-in from all involved, otherwise you will not have a great implementation.

In summary, EMR Implementation success is about communication more than anything else.