The EHR marketplace is in turmoil.
The past several years have seen Siemens being sold to Cerner, McKesson sunsetting its Horizon product (and later selling its healthcare division, affecting Paragon customers), and MEDITECH’s support of its Magic and Client Server platforms declining in favor of its new 6.x platform.
Amid such dramatic changes, many organizations have already gone to the marketplace to look for alternative solutions, only to find the price tag of a system replacement daunting. With one-time costs potentially running $50 million to $100 million or more, it’s easy to understand why some of those organizations have elected to wait.
But what are they waiting for?
Some expect to merge with larger health systems. Others are hedging their bets that a new vendor – perhaps with a more affordable, cloud-based product – will emerge. Some are hoping that interoperability will improve, thereby enabling them to ride out the term of their current investment.
The Problem With Waiting
One of the drawbacks of the wait-and-see approach is that the client base for these legacy systems is dwindling – so vendors have all but halted development for those products. Invision will not be certified for Meaningful Use Stage 3 (MU3). Siemens Soarian and MEDITECH Magic will support MU3, but they’ve told customers that only minimal enhancements will be made in order to meet regulatory requirements.
There’s certainly an element of sticker shock with any system replacement, but the data shows that most organizations using legacy products will spend the same amount (or more) in operating expenses as they would with a newer system – and with which they would gain additional functionality once the system is implemented. Legacy systems often require hundreds (yes, hundreds) of bolt-on solutions to keep running, which entails software maintenance fees and extra support staff. Continued investment in care and maintenance for these systems tends to drain operating budgets without any long-term benefit.
In addition to the escalating costs of running a legacy system, organizations that wait too long to replace are bound to encounter additional risks – from declining physician and patient satisfaction, to loss of market share if they don’t keep their operations current.
- Partnerships for clinically integrated networks or other population health initiatives may require development of even more throwaway interfaces.
- Those planning for merger may be less attractive to a potential buyer, who will have to factor the cost of an IT upgrade into the equation.
- Recruitment of residents and retention of medical staffs will become more difficult, as organizations with more modern systems will hold greater appeal. Physician burnout is a common issue for many organizations, and those that can utilize the EHR to improve work flow will benefit.
- Similarly, qualified IT resources who want to innovate will leave, not wanting to support an application soon to be retired.
- Lastly, but most importantly, patient satisfaction and perception of quality of care will become a competitive risk. Does your platform support a patient-friendly and advanced seamless clinical flow that your nearby competitors provide?
Any combination of these drivers for system selection should prompt an organization to reassess its IT platforms.
The Costs of Delay
Vendors have indicated that these products won’t be sunsetted for another five to seven years, but moving to a new system takes time. System selection to implementation takes at least two to three years. The client base will continue to erode during that time, and support for these legacy products will continue to diminish – if not disappear entirely.
Start-up costs for a new system will never be an easy pill to swallow. But with the incremental costs of operating an increasingly outdated system, the question isn’t whether you can afford to replace your EHR.
It’s whether you can afford not to.