Written by Stevie Davidson Tuesday, 14 December 2010 00:00

I have to write about a new client of mine that got himself into a bit of a situation due to the recommendation of purchasing a system through a Value Added Reseller (VAR), that has turned out to be quite a mess.  I know I have said time and time again, that doing your own due diligence around choosing an EHR and PM system is something that you and only you should own the responsibility of.  The recommendation sadly came to my client from someone he thought knew about ambulatory EHR systems since he is a CIO, but apparently his knowledge was quite deficient, and without truly knowing what he was speaking about led this physician and his organization down a path of operational and financial crisis.

In addition to finding out he paid an exhorbitant amount of money for the system, hardware, and training, the contract was not properly reviewed and has left himself unprotected, and with no leverage for a breach of contract.  He is also using this VAR to do his billing and that contract is even worse.  He just found out the product he just paid $80,000 for is being sunsetted.  He has not even been fully implemented yet, the training is still not complete, and the interfaces are not set up and he can't seem to get the company to fulfill their obligation.  Now the hard part, trying to recover a good piece of his investment to get a replacement product without putting him over the edge.  

It is a difficult time out there trying to navigate through the maze of healthcare reform, so  how you decide to embark on EHR adoption, transformation of your practice, and maintain the sanity of your staff, operations, and revenue is more important now than ever.  No one expects providers and their practice managers to be technology experts, and that is the common knowledge that many have and use to take advantage of this time of opportunity.  Unfortunately, it is always at the expense of the physician and the damage is often irreparable. 

Some key steps to protect yourself and the sustainability of your business and revenue should be the following:

1.  Hire an expert and do not do this alone.  It is common practice to see a specialist when there is something that will risk your health and this is no different.  This is the health of your business and you must treat it with the same care and importance.

2.  Take any recommendations of systems with a grain of salt.  Just because it works for a colleague or friend, does not mean it is right for your practice and how you do business.

3. Always have your contract reviewed carefully by an expert that understands EHR vendors and the implementation and support pitfalls.  Also ensure they are savvy with negotiating the best cost possible of your solution.  This expert should work hand in hand with your attorney, who will then in turn ensure the legal language and the contract as a whole is sound for maximum protection. This is an investment that should never be compromised and must be included in your budget.

4.  Take your time and plan.  Do not count on your vendor to streamline and transform your operations for you.  They take your current state and deliver on what you do today.  You need to manage your staff, operations, and clinical processes much differently in an electronic environment, and that requires careful and strategic implementation planning.

5. Do not fall into the trap of vendor idolatry, as well as taking the word of the last person you speak to as the gospel. Miscommunication is prevailing in the industry and it is leading providers down a dangerous path.

6.  Make sure your entire practice is involved in the process and educate your patients well ahead of time.

7.  Do not skimp on training.  Please make sure you purchase enough for the providers and staff.  Do not use self-tutuorial and online training as the primary vehicle.  There is no substitute for on-site training and education.

8.  Make sure that you incorporate all of the compliance rules and regulations into your workflow that you are now responsible for.  Practices are being audited for RAC and Privacy and Security compliance.  The fines are already hitting and you want to keep your money, not give it away.

9.  Never stop reinventing yourself.  You must continue to optimize your system, implement audit processes and mechanisms to ensure compliance for patient safety and risk management are adhered to.  Provider and staff accountability to maintain optimal performance is the key to maintaining the stability and enhancement of your revenue.

10.  Get a qualified IT person to manage your infrastructure, hardware, and software.  The vendors will support their EHR software, but having a professional that specializes in managing systems in medical practices is extremely important, especially with the new privacy and security laws in place.  Have your servers backed-up and maintained through a reasonable managed services contract.  It isn't just the practice management system anymore.  All of your patient's clinical information needs to be properly stored and protected.

It is not going to be an easy task to recover the damage that has been done to my client, but I know we will prevail because that is what we do.  However, please take my ten steps to heart.  I am a physician advocate and protecting providers is my passion, but I like to be proactive and help them succeed with a good foundation, not trying to undo unnecessary damage caused by unethical and irresponsible individuals and having it cost them far to much than it should in the end.

Until next time.....

Stevie