May 17, 2011 10:00 AM

I had a discussion earlier this week [original blog post dated May 4, 2011] with an EMR vendor who described an interesting trend. It is his impression that as we move along the adoption curve for EMRs beyond the early adopters and early majority into the late majority, it is becoming more difficult to implement EMRs in medical practices.

The reasons are likely multi-factorial. Here are a few that make sense to me:

• Physicians in the late majority are more demanding of the functionality in their technology tools and less willing to be tolerant of technology that does not work the way that they expect.
• Practices are less prepared for an EMR and are jumping on the EMR bandwagon because they feel pressure from colleagues and clinical programs to do so.
• The physicians and staff are not as willing to commit time and energy to health IT and EMRs; they simply want to focus on care delivery and potentially have different expectations of an EMR.

What is the evidence to support this hypothesis? The EMR vendor explained that in small practices with two physicians and two staff, the need for training has increased 50% when comparing similar practices four years ago with practices today. This size of practice is very typical of a GP office and makes up a large portion of physicians yet to adopt an EMR. His impression was that the user needs and demands had changed and that the further out one goes to the right side of the model, the harder it is becoming to achieve success without changing implementation methodologies.

There are other issues that also play a role:

• Due to the current focus on requiring vendors to meet functional requirements for their EMR systems, there is a limited focus on improving the usability of EMRs and vendors do not have the resources to commit to usability improvements.
• Without clear strategies to deal with E-Prescribing and the Referral-Consultation process, there are still very big gaps that have to be managed using paper processes. Once these issues have been resolved, the value proposition for the late majority will be significantly higher.

So, who should take responsibility for supporting the late adopters? Does it fall on the shoulders of vendors? Should more money be provided to increase training levels because of the higher demands of this group of users? Is there a need for more web-based education and readiness preparation programs to improve a baseline level of competency?

Clearly, these questions need to be dealt with using creative approaches. Who is going to take the lead?

Do you agree with this posting? Have you had similar or differing experiences? Add your thoughts by clicking on the “Comments” link below.

Originally posted on Canadian EMR

Blogger Profile: Alan Brookstone
CanadianEMR is an authoritative and widely recognized national resource for physicians, medical office staff, healthcare planners, government organizations, and vendors of EMR systems.

Posted by Sue Ansell at May 17, 2011 10:00 AM

Categories: eHealth

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