Holding up under pressure…


In the next three weeks, the proponents of the New Brunswick EMR monopoly will ramp up the pressure on physicians to accept the “One Size Fits All” business plan.

At last report, 34 doctors were using the government-sanctioned Velante product.  The target is 500 by the end of the month.   Obviously, there is work to be done, and you can expect the phone calls, emails, and knocks on your door to intensify in the days ahead.  Don’t be surprised if you see a full-page ad in the local paper!

Here are a few reasons why you may not want to succumb to Velante efforts to stampede you into making a hasty commitment, and a few questions you need to answer before making a decision which will permanently change your style of medical practice:

1.  Signing on to an EMR vendor – any vendor – may lock you in to a proprietary information silo from which there is no easy exit.  Remember when you were a kid and you wriggled into that tunnel in the snowbank and then got stuck?  You get my drift.  At this point in the evolution of electronic medical records, once you commit to a product, it is no easy task to switch to a better product later on.   To do so may cost you tens of thousands of dollars, negating any benefit from snatching up the government handouts available via Velante’s “limited time offer.”

2.  Once committed, you are on the hook for a minimum fee of close to four hundred dollars per month.   Versus some of the competing products, such as Oscar, which cost about a quarter of that.   The money you save when you reach for Velante’s golden carrot will quickly be consumed by the monthly maintenance fee.

3.  Can you type?

4.  Have you looked at other EMR options?   Before making the switch from paper to digital you should have a good understanding of the strengths and weakness of the different systems you can buy into, as well as the start-up and long-term costs.   Talk to someone using Oscar, Practice Solutions, Nightengale, or others.   Talk to someone who has actually used the Velante product.

5.  Weigh the relative benefits of a storing your patient information in a “cloud-based” repository versus a local “server.”  If you are unsure about the implications of each form of data storage, it would be prudent to do some research.   Have you ever called a cable company about a service interruption?   I have.   It’s not for the faint of heart…

6.  Do you really want to support a product which can’t stand on its own in a competitive environment?  If the Velante product is as great as the sales people are saying, why can it only succeed if fair competition is banned?

7.  Do you want to spend the next year or two struggling to adapt to a totally alien way of running you practice?   It was worth it in my case, but if anyone tells you that making the transition to a EMR will be a breeze, walk away… briskly…

8.  What happens when you retire, if you are not able to find someone to take your practice?   How do you maintain your electronic records for years and years after retirement?   Do you have to keep paying four hundred dollars per month to keep the records intact and properly maintained?  I don’t know the answer.   I’m just asking.

9.  By signing on to Velante, you are supporting an exclusive monopoly.   Monopolies drive up costs, erode customer service, and stifle innovation.   If that doesn’t worry you, here, borrow my pen and sign on the dotted line.

10.  Treat this decision the same as any other major life decision.  Be cautious.   Do your research.   Check the facts.   Talk to people you trust.

Contrary to glossy promotional material you may have seen, an EMR will not make you 30 years younger and better looking than you are now.   Your office will not suddenly be transformed into a gleaming, walnut-trimmed paperless showroom.  Your staff will not walk around with foolish, ear-to-ear grins all day long.   Your lab coat will not suddenly be whiter-than-white.

If fact, your days will be longer or you will see fewer patients per day at first.   You will need to go through the arduous process of “populating” your database, which will consume literally hundreds of hours of precious time for you and your staff.   Your receptionist may decide it’s not worth the struggle and leave for greener pastures.  You will question your own sanity for making the change.   But if – and this is key – if you choose the right EMR product, it should all be worth it in the end.   Most people who commit wholeheartedly to a quality EMR product don’t ever want to go back to a purely paper-based system.

If you have any reservations about making the change, take your time and make sure you know what you are getting into.

People who have had to change from one EMR to another, for whatever reason, have said it is just as painful and expensive as getting divorced.

Choose wisely.

Those of you who know me know I used to do a bit of SCUBA diving.   All told, I had logged close to 200 dives, almost all in the Bay of Fundy.  I am quite familiar with the currents, frigid temperatures, and  murky waters of this bountiful but sometimes hostile environment.   Most of all, I know how dangerous pressure can be.

If you are not properly outfitted, informed, and prepared to deal with pressure, the consequences can be harrowing.

Make sure you’ve done your homework before making any major business decisions.  The ten issues raised above are only the tip of the iceberg.

If you are seriously contemplating implementing an EMR in your office and want to learn more, you may find the following a useful starting point:   Canadian EMR Vendors


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