The news that Wal-Mart was entering the electronic medical record market via its Sam’s Club subsidiary has been a hot topic, with many physicians raising doubts about how successful the venture might be.

The EMR offering is the result of collaboration among Sam’s Club, Westborough, Mass.-based eClinicalWorks (eCW) and Round Rock, Texas-based Dell.

The New York Times first leaked the story in March, but the companies waited to release the details at the Healthcare Information Management Systems Society’s annual conference in Chicago last month.Lack of details surrounding the EMR, led to many questions about how Wal-Mart would pull it off.

“I would say this is a pretty bold move on Wal-Mart’s part. But if it’s is done correctly it could help jump that hurdle that doctors have, because it is a huge risk for doctors to implement right now,” said Kevin Pho, MD, a physician who writes a medical blog called KevinMD.com.

“If Wal-mart can smooth out the bumps for small practices then I think that it will be a good thing, but as they say the devil is in the details.  I would say that I am cautiously optimistic right now,” he added.

Officials announced at the HIMSS conference that the EMR would be available in Virginia, Illinois and Georgia, as part of a phased implementation that will be offered to physicians nationwide later this year.

“I never thought I would see the day when EHRs are on the aisles with soap flakes and socks, commented David Brailer MD, former federal healthcare IT czar, “EHRs have truly become mainstream American products.”
As it turns out, EHRs will not be stocked in the aisles like other staples. They will be available through Sam’s Club online.

Girish Kumar Navani, CEO and co-founder of eCW, put to rest the idea that doctors will be able to pick up an EMR along with their other purchases at Sam’s Club. Although physicians may be able to get information about the EMR, it is purchased online, much in the same way practices currently purchase an EMR though eClinicalWorks, he said.

The EMR software is provided by eClinicalWorks through its software-as-a-Service (SaaS) model. Dell provides the hardware components including three Dell OptiPlex desktops, one Latitude XT convertible tablet, one fax server and one laser printer and applicable switches.

The training, which is 12 weeks of implementation and five days of onsite training will also not change Navani said.

Dell will provide the necessary hardware and site assessment, onsite technical set-up and training as well as integration of the software with the operating system, along with hardware warranty support.

Pho questioned whether eClinicalWorks had enough manpower to provide the support that a large distribution center like Sam’s Club would need.

However, Navani said in preparation for the increase in technical support eClinicalWorks hired 70 people. In the next year it plans to hire 500 more people to provide training, project management and support he said. 

The EMR will cost $25,000 for the first physician in an office and $10,000 for each additional physician. Navani says this cost includes, hardware, setting up the data center and infrastructure, training, practice management and the first year of support and maintenance.
“It is a fully comprehensive package,” he said.

He pointed out that a comparable system package would cost almost twice as much.
Rob Lamberts MD, who has a blog called “Musings of a Distractible Mind” agrees the pricing is hard to beat.
Navani said eClinicalWorks’ relationship with Wal-Mart is a very logical one. “Wal-Mart believes in saving money and living better and that vision is possible with healthcare IT.”

“You have to tip your hat to them, look at what they did with the $4 prescriptions that was a really good thing for the public, said Lamberts. “I don’t know if this will be a huge money-maker for them, but I think they are doing a good thing for the country and maybe they are.”