What Should You Do with a Failing EHR?

Unfortunately, you need to protect your practice and your patients against a failing EHR.  Some recent examples demonstrate the vulnerability of any practice to a failing EHR:

An EHR cloud service added customers which resulted in substantial delays for the physicians in the practice.

A new version of an EHR resulted in thousands of records disappearing from the patient database.

Physicians discovered that old patient plans were being printed as the current visit plans due to a program error.

Support from the vendor failed due to a shortage of staff, too many customers, or problems with the software.

With over 1,000 Certified EHRs and more on the way, practices face a dizzying array of EHR product options and vendors.  As a practical matter, not all of these products will be successful.  Indeed, physician practices need to seriously monitor their vendors and communicate with vendors on any concerns that may evolve with use of their product.  Your practice needs to monitor the stability of your EHR product and the vendor that is behind the EHR.

If you practice does encounter serious EHR problems, you need to protect your patient’s medical records and preserve the integrity of patient care.  When encountering an EHR reliability problem, practices need to undertake a protection and recovery effort.  

Protect Records - Protection activities may range from holding a backup from your backup rotation to moving documentation to paper charts.  For example, one practice was using an EHR that stopped correctly generating the exam notes.  The practice moved their chart back to paper since their EHR had become error prone and unreliable.

Remediation - The remediation effort should include assessing the damage and trying to recover information.  For example, the practice should assess the reliability of the current information and make sure that they recover missing information from patients as they see patients going forward.  You may also be able to gather relevant information from your billing system, and other parties such as labs, hospitals, etc.  For example, a pediatric practice may recover some immunization information from the billing system or immunization registry.

Document Due Diligence - The practice should document EHR problems with appropriate letters and paperwork to EHR vendors to demonstrate due diligence in trying to protect your patient records.  In too many cases, practices accept EHR vendor explanations for problems without communicating the impact on their organization or records.  Failure to document the problem and the practice response could cause operational problems and a variety of legal issues.

The best defense against a failing EHHR is to monitor the performance and well being of the EHR that you use and your vendor.  Make sure that any changes to management or software is understood and evaluated to verify the continuing reliability and viability of your EHR.  For example, if a vendor is moving their EHR offering to a cloud product, then you need to seriously evaluate the vendor commitment to your current inhouse system.

In most cases, practices with failing EHRs encountered early warning signs, but failed to act.  You owe it to your practice and your patients to monitor the health of your EHR and develop a go forward strategy before you are caught in a difficult situation with a failing product or vendor.