I observe entirely too much emphasis on the ability of the EHR to reproduce current practice workflows and I am generally leery of putting too much emphasis on the concept of the “Right EHR.”

The model of practice is changing. We are motivated by concepts of accountability, patient centeredness, value-based purchasing, and shared savings. An EHR that supports current workflows can give an organization a competitive disadvantage.

Choosing the “Right EHR” might be like choosing the “Right Spouse.” Yes, there are some obvious selection criteria and very clear wrong choices. But the right choice may only be definable looking back, if it’s ever clear. And the commitment may be more important than the choice.

In my experience, all selection criteria are incomplete. The data available to match to the selection criteria is often absent or inaccurate. The people making the selection are inexperienced, having never used an EHR before. And all EHRs are flawed. When it comes down to implementation and use, I have seen wonderful work done with any good EHR and, in different locations, terrible frustrations around the use of those same EHRs.

The critical selection factors appear to me to be: Have a clear and shared vision of what is wanted and needed out of the EHR, an organizational commitment to make it work, and a responsive vendor with a compatible vision who looks like they will be around to keep it working and evolving.

Note: These comments first appeared as part of a Medical Group Management Association (MGMA) discussion on LinkedIin.

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