Selecting an EMR: Ready, Set…Go Compare! is a series of blogs that serves as a resource for physicians who have decided to select and implement an ambulatory electronic medical record (EMR).
Electronic medical records (EMRs) admittedly have nothing to do with French toast, but common pitfalls encountered when selecting an EMR for a physician practice are very similar to the pitfalls encountered when going grocery shopping. Consider the following series of events subsequent to my family deciding at dinnertime that I am going to cook French toast for breakfast tomorrow. Knowing we are out of milk I realize I need to go grocery shopping this evening in order to be prepared for the morning. I check the refrigerator and note that not only do we need milk, but we need eggs as well. I check the bread drawer and see a nearly full loaf of bread. When looking in the spice cupboard I see a small container of cinnamon, but it is nearly empty. With eggs, milk and cinnamon in mind I proceed to the store and go promptly to the dairy section. After selecting the needed milk and eggs I head back toward the front registers. Along the way, however, four other items conveniently catch my attention and find their way into the grocery cart. I had quickly convinced myself that not only were they were needed, but they were also good deals.
In retrospect, I was wrong about that. But at least I maintained some semblance of shopping discipline by resisting the temptation to pick up several other items that were on sale such as maple syrup.
I drive home and begin putting groceries away. As I put the first “extra” purchase into the pantry, I am disappointed to see that my wife had already purchased a large quantity of the same thing. My purchase subsequently sat on the shelf unused and was thrown out a year later when it reached its expiration date.
As I put the second extra purchase away, I was happy to see we have none of this item. However, as time went by we never needed it. It was also thrown out a year later when the expiration date passed.
As I put the third extra item away in the refrigerator, a delicious family dessert, a cold, dark feeling creeps through my chest and stomach as I read some fine print on a label that I had not seen while hurrying through the store. My fear confirmed-- it contains peanut traces. My daughter is severely allergic to peanuts. I had made this spontaneous purchase with family enjoyment in mind. My wife and daughter did not experience the intended joy.
As I put the fourth extra item away, a kitchen appliance that was on sale at half-price, my wife walks in and remarks how happy she is that I had remembered to get a replacement for our broken appliance. However, this half-priced, off-brand appliance never worked the way it was supposed to work. We threw it out within a month.
The next morning I get up early to fix the French toast. When I open the bread sack I discover that it is moldy. When I look for the maple syrup in the cupboard I find none. I now spend added time and effort to go back to the grocery store a second time. I realize that I am fighting a fire that I could have prevented with better preparation the first time. Its not the store's fault I was not prepared. For added insult the maple syrup is no longer on sale less than 12 hours from my first visit.
As I prepare the French toast, I lament over my failure to spend the time and effort necessary upfront to adequately identify our grocery needs. I lament lacking the discipline to create and adhere to a simple shopping plan. I recognize that overlooking the value of good preparation and making hurried decisions on-the-fly resulted in more work to do and ended up being costlier.
And then the final curtain falls on the French toast fiasco. In the same instant I initiate a motion of my right hand toward the spice cupboard, a hot pain sears through my head as I realize my failure to remember the cinnamon. To my mental lamentations I quickly add, “failure to write down a grocery list”.
The pitfalls encountered when selecting an EMR are quite similar to the French toast fiasco. EMR selection pitfalls occur when a practice fails to spend the time and effort needed upfront to identify a shopping list of what is really needed or fails to adhere to a shopping plan that maintains a disciplined focus on comparing how well EMR products align with the practice’s known EMR needs. These pitfalls include:
EMR selection pitfalls can cause a significant amount of dissatisfaction with the selected EMR as well as unplanned additional work, unplanned additional costs or even EMR implementation failures. The following strategy will help a physician practice prepare a “grocery list” of realistic EMR needs and establish a plan to select an EMR that is aligned with the practice’s needs: EMR Selection Guide provides an outline of additional topics on the selection process EMR Implementation Guide provides an outline of topics on the implementation process