7 Costly Mistakes Made when Purchasing EMR and Health IT

Database schema is great for the few geeks who can use it. For the other 99% of docs out there, particularly in small practices (the majority of docs), the schema will be relatively worthless.

More important is that the vendor include in the software, the ability to export all charts/encounters to at least the PDF format.  I say, "at least to the PDF format" because it is universal. It lacks computability.  Better yet would be the ability to export to the CCR.

Also ask the vendor how that export can be automated, allowing you, for example, to pick a beginning date, an ending date, and a button to click to export all charts to the CCR.

Of course, ask the vendor for a sample CCR file and review it in your browser for level of information.

The database schema and associated documentation actually is important to have access to - and not just for geeks. This gives you the ability to get at whatever discrete data elements you need whether they reside in your clinical EMR or practice management system. To be totally dependant on a vendor export is a mistake and leaves you dependant on the vendor as you cannot be assured that what the vendor provides you will always have everything you need in the right relationships. To get it in a PDF form doesn't give you the ability to get at the actual data in the event you need it.

Why not at least have this information should you need it in the future. It is a fair request, doesn't cost you anything, and expands your options.

And yes, it would be nice to also have an automated export capability in addition to the data schema. But remember various export formats do not neccessarily present you with all the data you might need.

As to the comment that it is only worthwhile for geeks to have - its easy enough to find an IT person should you need to actually utilize the data schema for your particular needs.  

Most of the bigger EMR products now have 3rd party support services available that understand the database schema.

For instance, we formerly used Medical Manager. When Medical Manager forced us to only use their claims scripts for EDI, we found several 3rd party solutions. We even got unsolicited mail from these companies offering to sell us cheaper and better scripts. When Medical Manager dropped support for version 9, we purchased it from a place called 'Final Support'.

If you look around, you will find independent 3rd party places that can work on Centricity, NextGen, eClinicalWorks, A4 etc, and extract information for migration to a different EMR.

Choosing a player that has significant market share can mitigate against the company leaving the market. Most bigger players would also be expected to 'sell' their product to somebody else who would then be able to migrate to a newer product, or spawn 3rd party conversions to newer competing products.

That being said, converting to a new EMR will be an unpleasant experience no matter what.

How many programs from 20 years ago are you still using today?

Visicalc, Lotus 123?

WordStar? MultiMate ? Turbo Pascal ?

This is a Getting Started resource contributed by Michael Uretz of The EHR Group . Michael Uretz, Executive