I wish somebody had told me what I'm about to tell you about converting paper charts to electronic medical records, had sat me down and set me straight about the ABCs of EMRs.
Told me that adding an EMR will be a headache at first, no matter which system you choose. That there will be a growth curve for our nurses and doctors, steeper for some than for others. That it will be challenging for a multispecialty center like ours from pain to plastic and most everything in between: GI, ortho, ENT and general that does 650 cases per month, to make everyone happy. That there will be costly upgrades. That it will make certain things more efficient (government reporting and QI studies) and other things less so (it can take longer to chart a pain injection case than it does to perform one). That surgeons will want to access your EMR from their offices. And that screens will freeze while you're in the middle of charting a case.
But when we embarked on our EMR project nearly 3 years ago, I was in largely uncharted territory. I don't want you to go down the same dead ends and blind alleys as I did. Here, no punches pulled, is what awaits you as you make the move to EMRs.
It's a big (and ongoing) investment. Our startup costs were more than $160,000: about $100,000 for software, $30,000 for servers, wireless systems and IT consultant fees, and $36,000 for hardware (20 15-inch laptops that cost $1,800 apiece). Then there are ongoing costs. We pay our vendor a $7,000 quarterly service charge for upgrades and 24/7 customer support (the help desk will undoubtedly ask if you have the current hardware when you call to report an issue). Pay attention to the fine print. Will the support fees increase every year? Are upgrades included? Be sure to budget for IT projects associated with adding an EMR, such as building infrastructure, buying add-on modules, cloud storage and cycling out computers every 4 years.