Findings from a recent Black Book survey shouldn't be much of a surprise to anyone in the healthcare IT world: changing electronic vendors is expensive, time-consuming and full of hidden challenges.

Bigger health systems usually weather the disruption more easily and come out happier on the other end. Smaller providers, however, struggle to cope with hidden costs, user frustration, and longer than expected downtime, among other things.

Brand-name recognition and overeager sales pitches hid some of the most significant challenges providers encountered. Black Book found that 71 percent of providers who switched EHRs saw a drop in interoperability.

WHY IT MATTERS
EHRs are expensive, and also mandatory. When they don't work well or when physician buy-in to the system is lackluster, it eats into revenue which can already be strained to recoup on the cost of an EHR implementation.

Cost overruns or implementation delays caused temporary or permanent layoffs for 22 percent of those responding in the survey, not to mention additional headaches for the remaining staff and lost more money for the system.

Finally, clinician burnout, an already worrisome trend, can be exacerbated by changing EHR systems, something an astounding 98 percent of respondents said wasn't a part of the conversation as they switched EHR systems.

"No other industry spends so much, per unit of IT, on the part of the business that is shrinking the fastest and holds little growth as hospital inpatient revenues," said Doug Brown, president of Black Book.
                   
THE LARGER TREND
Black Book finds the majority of financially threatened healthcare systems regret switching EHRs – so changing horses mid-race might not be the first move a smaller or struggling provider might want to make. The survey notes that changing providers is a risk that many small healthcare systems are unable to make work to their benefit in the long run.

Instead, taking steps such as recognizing the impact of physician burnout, or directing more focus on achievable financial goals such as interoperability or greater functionality may be a smarter tactic.

ON THE RECORD
"In retrospect, mid-market system CIOs spent a lot of money focusing on functionality and incentive-dollar achievement, thus many did not appropriately approach long-term value by dealing with basic issues, such as departmental workflows, usability, interoperability and data-sharing standards," said Brown.

"We found the majority (69 percent) of struggling hospital systems in 2018 that are dealing with very tight margins – or even losing money – regret their IT choices, which still have them teetering between being able to stay open or having to close," he said.

Benjamin Harris is a Maine-based freelance writer and and former new media producer for HIMSS Media.
Twitter: @BenzoHarris.