“The EHR vendor lied to us, so we’re going to fight to get our money back,” they said. “We had a guy who sold us the practice management system a few years ago, so we thought why not buy the EHR from him as well. It will be easier that way because we can assume that the EHR will work just as well for us as the PM does.”
Yet another conversation for me this week with a clinic team member who shared a story of a buying decision made without defining the expectations of the clinic for the EHR vendor.
For those people who have an interest in investing or mergers and acquisitions, you’re probably familiar with the financial term “enterprise value”. If you’re not familiar with it, here is an excerpt and link from the Motley Fool wiki:
Enterprise value is the value of company, incorporating equity, debt and cash. It is essentially a way of measuring what it would cost to buy the company. Also often called total enterprise value (TEV).When you buy a company outright, not only do you get all the income and inventory and everything else, you also get the cash held by the company. So, in effect, you pay to buy the company and get some of that back immediately. For a debt-free company, that’s great. But many companies also have debt. That means you are taking on the obligation to pay that debt back as well, so you have to cough up the extra dough.
This concept of enterprise value is also important in the context of the clinic, especially with regard to EHR vendor relationship, when we add the words “due diligence”. This value is defined by the knowledge of the clinic staff, the nature of their interactions or human workflow, and best practices.
Knowledge of the clinic staff represents the criteria in the due diligence component of the EHR selection process that will determine fit in terms of usability. Why is this important? Because the EHR is either going be an enabler or an obstacle for your existing human workflow in the clinic. If the specific needs and expectations of all of those people with jobs to do in the clinic are not explicitly defined, then assumptions and oversights will prevail.
The nature of human interactions within the clinic and among some continuum for patients’ care must not be left to the EHR vendor to define on behalf of the clinic. We often hear the term “EHR workflow” and there are real opportunities to enable clinic staff in new ways with regard to the right person having the right information at the right time. However, the EHR vendor is not familiar with those preferences of all of those people doing all of those jobs in the clinic, not to mention how they collaborate with that information.
Whether it’s consistency in terms of treatment plans for patients or coding for reimbursements, best practices may be a talking point among the physicians and administrators that arise like a storm cloud when due diligence process is done.
The inherent nature of EHR software is in creating structure, and this can be a real obstacle within the clinic where individual philosophies have reigned for years. Resolving these conflicts in advance of EHR implementation will have a direct impact on the value of this resource as an enabler in the clinic workflow.
It’s impossible to delegate the responsibility for successful human interactions within the clinic and the associated community of care to the EHR. This dialogue between the clinic and EHR vendor is not about knowing a guy and especially assuming that the guy will just make this whole relationship magically come to life because that is his job.
Those expectations must be defined by those insightful people in the clinic and find their way into a negotiated contract that is mutually beneficial. The first step may just be recognizing the value of the physician and her enterprise value to the clinic along with the definition of EHR expectations today and beyond.
Robert Green is the author of Community Healthcare: Finding a Common Ground with New Expectations in Healthcare. Through his physician client relationships, Bob has gained substantial insight regarding the daily challenges that medical professionals and their staffs face, such as regulatory issues, financial management, and clinical collaboration through the use of health IT. His process of making both interpersonal and purposeful connections within the organization results in improved employee performance and confidence and enhanced client experience. Source
