Comment by bonsai_spool

2 days ago

> EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.

Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.

> This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.

Epic is one of the few providers who can meet a larger organization's overall needs

The competitors, like eClinicalWorks, are a shadow in comparison

No doubt companies increase revenue with more efficient capture of services, costs, labor factors, etc, but I've actually been in the room with people from Epic and have heard the sales presentation. I'm betting I have a decent grasp on both what they're selling and what the buyers are asking for.

  • > but I've actually been in the room with people from Epic and have heard the sales presentation. I'm betting I have a decent grasp on both what they're selling and what the buyers are asking for.

    This may be true but it is different from your earlier claim about an upcoming deadline forcing any change in EHR, which was clearly false.

Revenue cycle issues are important but not the only factor. It's simply no longer economically feasible for provider organizations to maintain bespoke EHRs. The costs have gone up too much. They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules compliance and escalating user expectations.

  • > They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules

    Yep, and more and more payors - government and private - are demanding systems that are both interoperable and audiable

    Internal, bespoke systems are notoriously nightmarish for auditing

    • As opposed to the Epic MUMPS pile?

      Epic has been sold in in Denmark and Finland, where it was a disaster, and then in Norway, where they failed to take lessons from the disasters. I don't think it's federal requirements which is the selling point there, though I wonder what the hell the selling point is, or what the Epic sales people put in acquirers' coffee.

  • I'm not talking about bespoke EHRs - the GP made the claim that only governmental insistence compels EHR decisions. If that were true, there wouldn't ever be a change from one EHR system to another.

    But these get announced all the time, so the premise is false.