EMR: Buy Now vs Buy Later

This topic has come up in many recent blogs. When is the ideal time to buy an EMR? Is it now so the customer can display meaningful use to get the stimulus money? Should customers wait to find out what the certification is going to be and make sure their prospects will be certified?

Bottom line, the ARRA stimulus "incentive" has inhibited and skewed the compelling reasons for EMR implementation by dangling the 44k per provider. Physicians should not want to implement an EMR simply because of the stimulus, they should want to because EMR systems have proven value over the years prior to ARRA. When implemented and used properly, an EMR can increase patient satisfaction, limit wait times, increase patient flow, improve E&M coding, decrease insurance premiums, increase work/life balance and the list goes on and on.

Someone made a very good point saying that the stimulus money should be more directed to the interoperability of these different systems rather than the adoption. EMR has been evolving for over 20yrs, interoperability is lagging however. Leave the EMR selling to the vendors, we will convey the compelling reasons for EMR adoption, the government doesn't need to sell it by throwing money at it (which it has been doing for all of our nation's problems).

Now the physicians are in a defense mode and uncertain who is telling the truth out there. You have some companies offering financing...are you kidding me? First of all, if you need to finance a system, you can't really afford it. Plus, you are paying interest so the system will cost you more in the long run. You also have some sales folks assuring their prospects that their system will be certified...by who may I ask will certify them? How do they already know this info? Am I missing something here?? I have also heard of vendors guaranteeing meaningful use. MU is up to the customer, not the vendor. How can they guarantee this?

Point is, Customers need to do their due diligence. Research, research and more research. Hire a fancy consultant if it makes you feel better, but don't let them persuade you to a program they think is "cool" or are partial to. Make sure your decision is based off your own and your staff's opinion because you are the ones that will be using the program everyday and your business depends on it.

So should you buy a EMR now or later? The answer is....depends. If you have already done your homework and found a system that completely fits your business model and you have staff buy in, I have to recommend implementation as soon as possible. This way you are ahead of the curve and can even have a better chance of attaining the stimulus money. If you are waiting until all final MU and Certification criteria is completed, you may be behind in attaining the stimulus money, however you at least know the criteria and can make more informed desicions about EMR selection.

David vs Goliath

EMR vendors can be broken down into these two categories. In one corner, you have your small vendors whose company size ranges from 10-50 people to include developers, administration, customer support and sales. In the other corner you have the Goliath's i.e. large vendors that have an employee base of over 1000 people.

What makes a customer choose a smaller company over a large one? Does is really all come down to a name? Do people get the warm and fuzzies when they go with a large company?

The main reason why I bring this up is because this scenario is played out consistently with my prospects.

One situation involved a nephrology group of about 25 nephrologists at multiple locations in the Northeast. The sell started out easy. I called in and left a message for the Practice Manager and received a call back the next day...amazing start! (My fellow sales people know what I'm talking about). The PM and I spoke on the phone for a while and I developed a great rapport with the PM as I grew up in the same area and we had some common interests. After the chit chat, we started talking business. I went into the specifics of the application, how it was developed and gave her some historical info on our company. This is where I lost her.

She figured our "small" company couldn't handle the large group she is running with its 24 nephrologists and $2 million/yr revenue. To combat this, I assured her that we were more than capable of handling large practices as we already have large groups in other medical specialties, including a nephrology clinic bigger than hers in which we partnered with to develop the application. Long story short, there was no winning her over. Her mind was already made up. She would rather spend the 100k+ to implement a "Goliath" system just for the name. She even admitted it.

To some degree I can't blame her. We all do it as humans. We want the biggest baddest product we can afford (or sometimes can't afford and buy it anyways). Yes, you get some kind of sense of security, be it true or false. You also get that sense of pride when you speak of your large purchase, vain yet true.

In the sales world when faced with this I have to imagine that this decision is made based on self preservation. It is easier for the PM to sell her decision when she has a branded name to sell. If she mentioned my company to her superiors, they would have no clue based on the name and have to do some work to find out about the company and its product. However, if she pushed a big name "Goliath" vendor, there may be less push back from the ultimate decision makers because they may have heard of the large company through marketing campaigns, tour buses and other professionals in their field. All of this is, of course, just my speculation. Maybe there was somewhere in there where I missed an opportunity and muffed up the sale. She did say however, that our product was probably better than the competition, but she wanted to go with a large company even if it meant more money.

Point of the story?

There are a few....

1. Once someones mind is made up, you have a very small chance of changing it

• Walk your prospect down the right path. You can't make decisions for them, but you can sure influence their decision making during your sales cycle.

2. Know who you are selling to

• This was a large deal for me and I went into it blind, shooting from the hip as they say. I should have already known our short comings and have been prepared to first steer away from them by selling our values and if it came up, be ready with rebuttals. By referring to our large clients and client base, I am able to portray with more validity of how we can accommodate her practice.

3. Sell through the Gatekeeper

• In this case, the Practice Manager was a decision maker but still the gatekeeper. She was covering herself by choosing a big name company because she was given a large budget. If I sold her better right off the bat, maybe she would be a customer today. If I were able to get her on my side and have her be my voice to the ultimate decision makers, then things may be different. Its important to always sell AND educate. Once the gatekeeper has been sold on your product, they can be your selling voice.

Finally, when it comes to choosing an EMR solution make sure it is one that will fit your practice. This goes for price and for functionality. ARRA is giving away 44k to adopt a system. Most large vendors cost much more than 44k so where is the incentive? It's like someone giving me 1 million to put down on a G5, where is the other 58 million coming from?

I know all small companies are not the same, but I have to go off of what I know. (And no, this is not a plug for my company). Most smaller vendors are practically giving their applications away. We are cheaper because we have less overhead....simple stuff. Our company has no marketing dept...we have developers, physicians, surgeons, customer support and sales.

From what I have heard from other physicians who have already implemented a branded EMR, they hate it. There is no customer support, or at least what I have heard is "too little, too late". I'm not knocking the large vendors here, but why would they get back to a 2 physician practice when they have large hospitals to keep happy.

I believe large vendors are perfect for larger organizations. They have the support and can be afforded. In my opinion, smaller vendors have the advantage on large vendors when it comes to smaller practices. There is less red tape and quicker results. Speaking for myself, if a customer calls in and wants a special report done that's not already in our system, it typically takes only a day and costs our customers nothing.

I have heard of implementations taking months, ours takes about 10 days.

In these tight times, people have to do their homework. Ask your vendor the hard questions and be secure in your final decision because once you implement a system, there is almost no turning back.

My Very 1st Blog

Well, I finally made it. Feels different but I'm open to change and pride myself on adaptability...eventhough some may say I am hard headed and stubborn. Afterall, it took me this long to start blogging.

My compelling reason to blog? Why HealthIT of all things? My main goal of creating my very 1st blog is to learn. No I am not a HIT guru...yet, however, there are many of you out there and I hope through this blog, I will be able to learn more through others' experiences. I also hope to gain followers like me, who are new to the healthcare industry, and provide a platform for them to speak up, ask questions and learn.

Let's see how this thing goes.....