10 Hidden Cost When Implementing an EMR

It seems the tides are turning. With all the government incentive talks, meaningful use guidelines and healthcare reform, doctors are starting to really look at implementing EMRs.

Deciding on which EMR to choose is no easy task. How to implement it with the least amount of burden is also a challenge. Fortunately, there are countless articles online that will help with these tasks. And there are many consultants that can help you with this process as well.

One area that I think hasn’t been explored enough though, is the hidden cost of implementing an EMR. The surprise expenses, the things nobody told you about, the stuff the vendor forgot to mention, the oh by the way, you’ll need to buy a few more xyz if you want to abc…

I caught up with Chip Hart. Chip is a pediatric practice management consultant and he also works for PCC, which is a pediatric software developer. He’s been playing this EMR, medical practice technology game for quite some time, so I thought he’d be a good resource to help others – that are in the process of implementing an EMR – what to consider in terms of expenses.

I asked him to tell me what where the 10 common hidden cost when implementing an EMR and here is what he had to say:

  1. Is a telephone/Internet upgrade required? This is especially true if the practice has more than one location or if the practice is using an ASP model.
  2. Count up your maximum required tablets/pads/etc. on any given shift and then add 50%. The practice will inevitably have one or more units “in the shop” over time.
  3. Plan to buy extra batteries for all your portable equipment.
  4. You will need to store your new equipment, safely and securely. Chip says they’ve had a few clients have their shiny new laptops collections stolen from the office. Note that the practice will need space and to spend extra dollars in making this accommodations.
  5. If you already have a Practice Management software in place, note that the interface integration charges can be significant. More importantly, the functionality can be nebulous.
  6. Training needs is also something to consider. It is the norm for vendors to limit your training – it’s the most expensive part of the deal for us. Add to your training your configuration time, support requirements, and post-online follow up. If your training is counted in hours, then be prepared to wish you had more.
  7. Don’t forget IT expenses. I have seen some RIDICULOUS IT quotes given to our clients in the last 12 months. I know clients who pay more for a local guy to load virus programs and “support” their network than they pay for their EHR or PM and all that entails. Lately, this is has been the biggest culprit for unexpected costs.
  8. There are some big ticket upgrades coming soon. A few vendors are making waves for charging for “ARRA” upgrades. They will soon be charging for “ICD-10” upgrades, etc. A few well known vendors made WSJ back in 1999 when they made a fortune on Y2K upgrades.
  9. Plan for reduced productivity. Yes, I know all about practices who lose little, if any, productivity but that is exceptional. In fact, some offices also have a LOWER E&M distribution after going on-line because they are finally charting properly.
  10. Is there any chance that this revolutionary change in your office will cause you to lose any employees or providers? You’d be surprised how often it happens.

Bonus Tips: Staff overtime, doctor overtime

6 thoughts on “10 Hidden Cost When Implementing an EMR”

  1. Brandon, your list is excellent! Here are a few more issues that come up:
    1) Cabling for wired systems or repeaters for wireless systems are sometimes more extensive than originally estimated. Or worse, your plan to use wireless technology just doesn’t work because of building construction, etc.
    2) Software vendors that underemphasize the need to pay extra for software applications such as report suites or e-prescribing.
    3) To certify Meaningful Use and earn the HITECH Act incentive payments, you must be using Certified EHR Technology. You can do this with a modular approach, e.g., getting some functions from the EHR software and others from the Practice Management software, but the PM software must be certified for those functions. And of course in the long run, we can expect EHR vendors to cooperate less and less with PM vendors on interfaces, leaving you with some really tough decisions.
    4) And finally, one Meaningful Use objective is to perform a HIPAA Risk Assessment, something an EHR or IT vendor will be unlikely to do. But it will cost you time and effort internally, or consulting fees externally, to get it done.

  2. I totally agree with IT expenses and some of the crazy quotes we’ve seen from competitors. It seems that some IT companies are just looking to take advantage of a situation to sell unneeded products or services while not providing services or knowledge that is needed. Typically these are from non-companies who can provide no value beyond basic network support. Practices who select a non-healthcare IT provider are not getting the full value they are paying for and in many cases, are overpaying. I think by working with a true healthcare IT support vendor value for each dollar invested will be achieved and they will provide support and guidance that extends well beyond IT systems. A good IT vendor for healthcare will have at least 5 years in supporting numerous EMR solutions including the one the practice has selected. The vendor should also have a team of healthcare IT experts and not just 1 or 2 people or again, a practice will not receive the value they need.

  3. I totally agree with IT expenses and some of the crazy quotes we’ve seen from competitors. It seems that some IT companies are just looking to take advantage of a situation to sell unneeded products or services while not providing services or knowledge that is needed. Typically these are from non-< href="http://www.mdtechpro.com/best-healthcare-it-support/&quot; title ="healthcare IT"companies who can provide no value beyond basic network support. Practices who select a non-healthcare IT provider are not getting the full value they are paying for and in many cases, are overpaying. I think by working with a true healthcare IT support vendor value for each dollar invested will be achieved and they will provide support and guidance that extends well beyond IT systems. A good IT vendor for healthcare will have at least 5 years in supporting numerous EMR solutions including the one the practice has selected. The vendor should also have a team of healthcare IT experts and not just 1 or 2 people or again, a practice will not receive the value they need.

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