Comment by classichasclass

So here's my story about this.

I'm a physician primarily working in an administrative capacity for a large local government (though I also have a background in enterprise computing and did that for several years both full-time and as a consultant). I'd lived through the horrors of the EHR transition at the large HMO I used to work for and was determined not to have that happen again.

We were selecting an EHR product and had it narrowed down to three main products which I won't name here but they're all major players and are still in the market.

I was representing the clinicians, so I selected the product "A" I felt had the best clinical support, the best clinical workflow and the easiest UI slope. So did the nurses who were selecting for nursing staff (we didn't coordinate our choices; we each legitimately felt this was the best product for our respective scopes of practice).

The billers selected the product "B" that had the best reporting and financials.

So, we on the clinical side were asked, can you live with "B"? Well, yeah, sure, I guess? We can make it work, but it's clearly less flexible, the workflow is clunkier, the decision support is less comprehensive and we felt would be more difficult for the physicians. The billers said adamantly that "A" was too much work to deal with the reporting and they wanted something out of the box. They were not willing to compromise despite our concerns on the clinical side, even though we'd have more facetime with the product than they would, and there would be less to bill if the physicians couldn't figure out how.

So the clinicians got overruled by the billers and "B" was selected.

I understand that the billers must have a say, but the billers are dealing with a small portion of the product. The billers managed to convince administration that their concerns were more valuable because their work translated into dollars. As if the clinicians' work didn't? How does that work? And yet I see this occur again and again in other clinical systems.

As a postscript, the local government's rollout of "B" went aground and we ended up with a cheap vanilla install of "D", which wasn't part of the original three and ended up pleasing no one, and is ironically the same EHR I still have PTSD from all those years ago.