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Pulling the Plug on an EHR

August 20, 2009
by David Raths
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How common is it for clinics or physicians' offices to pull the plug on EHR implementations?

Some numbers from a recent survey by the National Association of Community Health Centers jumped out at me. The report states that "a surprising number of health centers responding to the survey have actually installed an EHR and have gone through a de-installation process."

NACHC got survey responses from 362 community health centers in 2008. Of the 176 health centers that identified they had an EHR in place, 18 (10.2 percent) had gone through a de-installation process. That seems like a high number to me! The respondents didn't give reasons, but the report speculates that it could be due to factors such as lack of appropriate clinician involvement in the initial planning phase and lack of clinical leadership.

The survey highlighted other IT challenges safety net clinics face. Obviously, most mentioned that a lack of funding to invest in EHRs is a barrier. But clinic administrators also express concern about loss of productivity during implementation, lack of support from physicians and lack of project management staff. Indeed, 37 percent of respondents said they have no dedicated IT staff. Imagine trying to do an EHR implementation in an overburdened clinic with no IT staff.

On the positive side, the report notes that the Health Center Controlled Network model, which provides management, financial, technology and clinical support services to multiple clinics, seems to be working well.

It is likely that serving these safety net clinics will be one of the important goals of health IT regional extension centers, once they are up and running. Providing more support for clinicians and administrators in these crucial clinics will be key to avoiding more de-installations.

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