Changing Systems Might Be Your Best Choice
by Leigh-Ann Renz, 3.13.17
"Choosing the wrong EHR is worse than no EHR at all" - unfortunately, this is true. Being forced to use a system that isn't the right fit for your practice can cost you exponentially: in time, resources, money, frustration - and your staff's willingness to repeat the process down the road.
We often hear of organizations who are either "stuck" in an EMR contract...or sadly willing to make do with something that doesn't work because they're afraid of having to undergo the painful experience again.
The Inconvenient Truths
There are a few universal practice management system truths:
> It will be an investment: you can expect an initial up-front cost, training charges, fees for add-on functionality that's handled through a partner (such as e-Prescribing); and you will probably need to pay for some customization. You should also budget in ongoing fees for Support, in proportion to the quality offered: ie, onsite Support will cost much more than phone support, which is in a whole different category from email-only customer service.
> In addition to the system's price tag, your staff will pulled away from their daily responsibilities to train on the new EHR, transition into using it, and migrate data (whether transferring the client records in by hand, or simply fine-tuning if it's been done electronically). The entire practice will be moving to an entirely new system - while continuing to operate and serve patients. It's akin to changing the car's tire while it's flying down the highway!
> EHRs can be frustrating, especially for mental + behavioral health care providers. Our industry is often the last to change; and switching to an electronic program - or switching among them - can be especially hard on clinicians. Even if you can clearly see the practice management value in a system, be prepared for your staff to push back. If they don't, you'll be pleasantly surprised; but if they do, you'll be prepared to support them in their concerns.
> At first, it may not save you time! The ultimate goal of practice management systems is to make the organization more efficient, saving time and therefore money, while keeping data more secure and HIPAA compliant. Unfortunately, because of the inevitable learning curve, the first few months on a new system might be less efficient than your previous process. Hang in there, and if you find that the EHR isn't making your practice more efficient within six months, then you should consider alternatives.
> You'll need ongoing help. Think about how often you require professional assistance with your phone, computer, car, etc. Practice management software is at least as complex as any of those other tools. You should expect that your staff will need customer service on an ongoing basis. Make sure to ask detailed questions about Support quality and availability (and its cost).
While no system is perfect, and while you should expect the inconvenient, uncomfortable truths listed above, here are some signs that you're not matched with the right system and might consider switching (these can of course also be used as a litmus test for agencies purchasing their first mental health EHR):
Insufficient Training / Onboarding
Your ability to successfully use an EHR is directly proportional to your knowledge of the system. Without a smooth implementation protocol - and detailed, customized training - chances are, you won't be happy with your EMR because you don't know how to effectively use it. If you haven't received efficient and effective training; if the onboarding process didn't meet your needs; or if you've overpaid for these services, you should definitely take note.
Similar to training and implementation, not having access to responsive, prompt and professional support can negate any benefits an EHR might offer. If you can't get help in a timely manner, you're not able to use the powerful tool you've purchased. Pay attention to the cost and quality of customer service, both before and after the sale, and if you're left uninvolved, uninformed or unappreciated, it's time to consider switching systems.
As mentioned earlier, you can expect a typical disruption to practice workflow for 4-6 months after implementing a new practice management software. However, if things aren't back to normal by about six months (or if you find data that the new system is actually less efficient than previous methods), it's definitely time to contemplate a change.
We've already covered the costs you should expect when implementing a new software. However, if you start seeing: charges for upgrades / updates, hidden costs, or fees that seem excessive, ask questions and make sure the vendor knows you're keeping track.
Far too often, we've seen systems that were patched together to meet Meaningful Use requirements and aren't designed with the end-user in mind. This is especially true for mental health, which requires specialized niche functionality (think authorization management, group notes, UB-04 billing, etc).
Sadly, there are a lot of EHRs on the market that were extrapolated from general medicine and not designed for mental + behavioral health providers and practices. Make sure to ask your vendor how they meet the unique needs of our industry.
No Room For Growth
Given the intensity of switching systems, try to shop for what you expect your agency to be in 5-10 years, not what it is now. Look at any systems you're considering through the lens of growth: would they be able to handle your organization if you have the type of development you expect? Try to find a system that offers tiers of functionality and can therefore grow with your practice.
Not the Right Fit
No matter how much we all want it to be so, no system is perfect - and no one program is right for every agency. An EMR might look perfect on paper, but might not be the best fit for your practice. Don't be afraid to ask for references, check with colleagues and do your homework. And even if you diligently follow all of those steps, you may still end up with a system that's simply not the right fit. Sometimes, you just have to accept that the frustrations outweigh the benefits and consider a change.
For more mental health EHR tools, check out our EMR Resource Center and 7 Steps to Finding the Right EHR For Your Practice.
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