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It's Personal

July 17, 2011
by Bobbie Byrne
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How the EHR vendor selection process can pose a Rubik’s cube of decision-making complexity

As an officer of my corporation, I am obligated to act in the best interest of the corporation. Even if I did not have to, I have always taken my professional responsibility very seriously. I don’t like anything that even smells inappropriate. How a particular business decision should impact me personally should be irrelevant. But is that possible?

For many years, I was responsible for clinical strategy at Eclipsys. While there has been some turnover, I still have many good friends at “the new Allscripts.” Would I maintain these relationships if we went another way? I know and love the Sunrise Clinical Manager (SCM) product. I believe I could make that product sing. I always have one director with an advanced degree in “SCM,” and recruitment of the needed team would be fun and probably pretty easy, given the personal connections. The challenge of integrating the legacy Allscripts Enterprise application with the legacy Eclipsys product would be a good challenge. I am also a Chicago girl, and Allscripts is a Chicago company. It is the home team, and I know that we would get the requisite attention. On the other hand, it is not a single patient record—and that is something that is difficult to change.

Meanwhile, Epic is the darling of the industry. A successful implementation of Epicare is quite valuable on the resume. Plus, I really am a single-database kind of gal. I firmly believe that it will take that level of integration in order to really compete in the new world order—call it an ACO, value-based purchasing in healthcare, or any other buzz word. I like the Epic culture, and every single person I have met from there is crazy smart. It seems like a foundationally sound decision.On the other hand, we would be customer number 150. There is no special treatment coming, and the costs in both capital and staff to support are just staggering.

Finally, my organization has been with Meditech for a very long time, and I personally value that kind of history. They are newfound converts to the value of ambulatory care and physician alignment. I am not sure how strong their new religion is, but if there were some way to make the 6.0 product work in our environment, we could save a lot of money. Maybe even enough to build a building…maybe I can get my name on that building…?

So what is the correct answer? On what side should I personally land?

The answer for me is linked to the fact that I really like my job, and I am looking to be successful here far more than I am looking to enhance the resume. The decision made will be my bed. I will need to sleep in it. That means that getting broad input and buy-in to the decision is essential. When I think about what side I personally come down on, it has to be the right side—for the organization—which will then be the right one for me.



I like the coin flip idea!!!

It's in the mail...with my consulting contract since it really is not plug and play and requires months of training!

Seriously, it's a tough decision, no perfect answer, no perfect vendor. Kind of makes you wish it was more like a modern day marriage...letting you try before you buy.

Good luck.

The safe answer is to hire a consultant and pay at least $1mill for the project. That way any 'bad' decision can be blamed on...

Or you can fip a coin (I have a 3 sided one if you need)

Or you can buy Cerner /McKess/Siemens...

Or you can ...

Oh by the way, although Epic markets their system as 'single' data base it really has mutiple data bases that are linked together. Not unlike what other vendors would do, they just do it a little better. Careful don't confuse the marketing with the reality.