Friday, January 06, 2012

How Much Is An EMR?

MediNote EMR, courtesy Carson Doctors Group
I have to take a moment away from the compilation of the Advanced Visualization results to whine about something else: EMR's.

One of our hospitals is plunging headlong into the EMR quagmire, and I am on the EMR/EHR/EFR Committee (specifically the CPOE Committee) as a representative from radiology and things technical. You would think it a daunting task to upgrade a full hospital system to electronic status, and you would be correct. Fortunately, the IT types and physicians involved are very capable, and really interested in doing a good job, and I have been quite impressed with their efforts to date.

HOWEVER, we have a tremendous stumbling-block, and it relates to the software already in place. While not going into chapter and version (and not naming names, as I think I might have signed something that said I would keep my big mouth shut), years ago, a really bad decision was made to go forward with the version of HIS/RIS (what we used to call EMR/EHR/EFR) that was little more than a port of an old Data General green-screen terminal. In other words, we are stuck with 10-year-old technology emulating 20-year-old technology. It sucks. Period. And we now are charged with making a square CPOE peg, among others, fit in a rather ancient round hole.

You would think that in the process of upgrading, we might simply forklift out the old green-screens and buy something new. Apparently, this won't work. It seems that our small hospital system was told that it would cost $30 MILLION to replace the whole shebang. $30 MILLION. Yes, that would be MILLION with an M. Now, I'm not sure just who set that price, but it was accepted as gospel, and a heck of a lot of work is now predicated on the premise that we must update but not upgrade. Bah Humbug!

I need to poll the audience. Does it REALLY cost $30 MILLION to replace an EMR for a relatively small hospital system? We're talking 300 beds or so, not the Mayo or Man's Best Hospital. Really? Seriously? $30 MILLION!!???

If this is truly the case, somebody out there (I'm thinking Merge Healthcare has the wherewithal to do so) needs to reinvent this genre. I cannot believe that EMR/EHR/EFR's have to be this expensive, not to mention requiring a two to three year implementation period. It just doesn't make sense to me, and I insist there has to be a better way to do this. Right now, I think the software companies are frankly just fleecing their customers in their frenzy to comply with all the Meaningless Use crap from Washington. Please do feel free to prove me wrong.

$30 MILLION? I'm not buying it. Literally or figuratively.

7 comments :

Anonymous said...

We've been told a similar amount @ our 800 bed hospital. Why is it so expensive?????

Solitary Diner (Also Known as The Frugalish Physician) said...

Any sort of electronic data system, particularly if it's customized, costs a ridiculous sum of money for some reason. When I was involved with setting up a student-run health clinic, we were quoted tens of thousands of dollars per year to run a scheduling system that would allow us to schedule two shifts per week. Um...no. For that price, we could've hired a part-time real live person to do all of the scheduling.

Anonymous said...

If you follow the signing of new EMR contracts, contracts range from $45M to $250M. At least 50% of it is claimed to be the resources needed to complete the implementation. SW licenses, HW, 3rd party components make up the remaining 50%. Not saying it's right, just what it is.

Anonymous said...

I agree with the above post....we just spent $60 million on ours. Of course I think we chose the most expensive one....sounds like Sir-ner.

Anonymous said...

While I will admit a lot of work is involved in migrating historical data and getting a system configured specific to site needs I still think 30 million seems WAY to high.

I was involved in a fork lift PAC's project at an 800 bed hospital with 15 rural hospitals feeding into it and that was only a ~3 million dollar project. Granted, it was PAC's and not RIS and it didn't involve migrating data from a 3rd party system...

Anonymous said...

I remain dumbfounded with the health care Industry and why people accept old as dirt technology and even older ways of thinking is beyond my comprehension. I suppose it comes down to years of acceptance and limited solutions in the market place, and I thought the automotive industry was in the dark ages!!

DraconPern said...

Why is everyone so afraid of actually saying the vendor names?