Mandates and studies issued recently by the federal government have placed the need for medical practices to “go digital” in the headlines of papers and websites across the US.  Presidential candidates, each touting their own healthcare reform plans, preach that electronic medical records (EMRs) must be at the forefront of efforts to reduce the cost of healthcare and to improve the quality and safety of medicine.  It seems clear that traditional paper chart systems are soon to be a relic of the past.

What, then, to make of a recent study that shows slow overall EMR adoption rates and a high rate of failure among those who actually have ventured into this brave new world?

Nearly 20% of respondents to the Medical Records Institute’s (MRI) Survey of Electronic Medical Records Trends & Usage are currently “de-installing” an EMR or have done so in the past.  8% have fully returned to a paper-based records system.  Furthermore, 30% of users report only partial usage among their practices’ medical staff.

A recent article in Modern Healthcare magazine suggests that the disconnect between futurist visions and current EMR implementation rates are most striking within the ranks of medical specialists, such as otolaryngologists and orthopaedic surgeons.

Most EMR vendors provide solutions that are designed for generalized medical fields, rather than specialties.  Such vendors focus much of their R&D efforts and dollars on solving the needs of physicians such as family practitioners or pediatricians.  There are also some manufacturers who opt for an even wider approach, attempting to build systems that suit the needs of physicians across today’s very broad medical spectrum. 

However, MRI’s CEO, Peter Waegemann, recently told Modern Healthcare magazine that many EMRs lack the sophistication needed to be effective in specialized medical environments.   Mr. Waegemann went on to say that “If [an EMR] has been designed for everyone, for every specialty, you could almost throw it out.”

Indeed, according to MRI’s data, that seems to be what is happening.  It’s also what AllMeds, an Oak Ridge-based EMR vendor, has found during their 21 year history. 

Bill Rust, AllMeds’ CEO, states “We’ve found that EMR vendors serve both themselves and their customers best when they don’t try to be all things to all physicians.  Specialty physicians oftentimes find that generalized EMRs lack essential functionality when they’re shoe-horned into more specialized settings.  Many of our specialty groups have moved from one of the generalized solutions to ours for this very reason.”

The availability of clinical content is likely the driving force behind such results.  Clinical content is required to sufficiently document exam findings, diagnoses, and medical plans.  To be truly effective, an EMR must possess a comprehensive library of information that alleviates the need for physicians to document from scratch. Otherwise, both the workflow efficiencies and the documentation improvements touted by EMR vendors suffer.

But, according to Waegemann, “most medical specialty societies simply are not ready to ‘come up with the data’ around which vendors can design specialized systems.”  Therefore, most generalized EMR vendors put the responsibility for developing clinical content on the shoulders of their customers.  But, therein lies the problem.

Writing a comprehensive, usable library can take up to 400 hours of a physician’s time – time that is already in very short supply and very expensive.  The sheer amount of time required for such a task oftentimes delays implementations, frustrates users, and is one of the top reason behind EMR failures.  Some vendors rely on third party resources to sell libraries to specialty customers, but doing so oftentimes raises the overall cost and complexity of the solution to unacceptable levels.

AllMeds’ business model focuses only on a select group of specialty environments, including Otolaryngology, Orthopaedics, and Pain Management.  Such focus allows the company to adopt a different approach toward the issue of clinical content. 

AllMeds employs the expertise of a group of medical consultants in each specialty area they serve.  These specialty physicians develop exhaustive content that is installed with the EMR at the time of implementation.  The content continues to evolve and grow as the company leverages an expanding base of specialty users to build onto the libraries.

AllMeds’ libraries are considered to be the most extensive in the industry and provide physician groups with the ability to productively use their EMR on day-one.  AllMeds’ content includes specialty-based protocols and algorithms, patient information forms (PIFs) and correspondence, templated histories and specialty-focused CPT/ICD-9 codes, and prescription hotlists unique to each specialty. 

Rust is clear to point out the results of their specialization: “We’ve been very successful in the markets we serve and we’re very proud to have the highest customer retention rate in the industry.  Data from studies such as this one show that many EMR vendors have a hard time keeping their customers.”  In comparison, AllMeds has kept 94% of its customers throughout the company’s lifetime. 

Rust states that AllMeds’ unique approach to specialization delivers less expensive and shorter implementation times, faster returns on investment, and greater levels of success.  “It’s definitely one of the qualities that sets us apart from other vendors.  It’s not only what wins us business, but it’s what makes AllMeds a truly effective solution.  And, based on the studies we’re seeing, specialization is also what others believe makes the difference in EMR success…or failure.  Thankfully, AllMeds – and our customers – are on the right side of that equation.”