Four challenges for practices replacing EHR in 2016

As EHR technology continues to evolve and the regulatory environment continues to prod practices with either a carrot or stick to implement more sophisticated EHRs, there will always be a latent amount of turnover in the EHR market. Early adopters grow restless with older EHRs that are no longer fit for purpose and begin to consider replacing their existing system. This confluence of potential replacement buyers combines to create a churn rate in the EHR market that hovers around 15%. Although 2013 may have been dubbed (and perhaps prematurely so) “The Year of EHR Replacement”, as more practices consider replacing EHR in the coming year the churn rate will increase, meaning that 2016 will more aptly fit “The Year of EHR Replacement” moniker.

Survey data indicates that the number of practices considering a replacement EHR in 2016 range from 20 to 50% depending on practice size and setting. For those practices committed to replacing their EHR, what barriers will be present for practices contemplating a switch and what can be done to overcome these barriers?

1. Meaningful Use

Practices replacing EHR will consider meaningful use regulations with an eye toward making sure they remain in compliance for many years to come. In the next three years practices will be required to either begin attest to EHR Meaningful Use or advance beyond to either Stage 2 or Stage 3. Regardless of a practice’s status on the spectrum of meaningful use, a replacement system should contain functionality to meet all of the meaningful use requirements in the long term. An efficient method of confirming this involves matching the meaningful use criteria published by ONC with a vendor's existing functionality (not what it proposes it will do in the future) and determine if the system is adequate.

2. Cost

As in any other area of technology investment cost is an issue and EHR often carries a significant price tag. For example, research indicates that initial EHR costs average nearly $44,000 per full-time provider, plus an additional $8,500 in annual operating costs, for small group practices. Therefore, the process of selecting a replacement EHR should be considered on par with any other long term investment. Buyers should consider return on investment (ROI) and how soon this ROI will be realized from the new system.

Recommended reading: 2016 EHR pricing guide - detailed pricing information from leading EHR vendors

3. Alternative payment models

In early 2015 the Obama administration announced, starting this year, Medicare will begin transitioning from the current fee for service model to a pay-for-performance model. This trend will continue across all payers as efforts are made to contain healthcare costs by improving treatment outcomes. Given this fact, practices replacing EHR should ensure prospective systems have the necessary tools to monitor treatment outcomes and provide at least rudimentary level of analytical capability to flag problem areas.

4. The flooded market

To state that consumers have options in their choice of EHR products is an understatement. The current EHR market is characterized by a crowded field of competitors who respond to a high churn rate by aggressively attempting to improve their standing in the marketplace. Therefore, simply looking at a few vendors and not examining a vigorous sample of options may result in some vendors - who offer the right balance of functionality and price - being overlooked.

Replacing EHR is not abnormal given the shifting expectations found in meaningful use requirements and the continued evolution of EHR products, however not recognizing the barriers inherent in the process of replacement could result in wasted resources and being forced to enter the replacement market at the wrong time.