Paying to computerize your records: How low can you go?

Size isn't everything. With electronic medical records, the key is to match what you need with what the EMR supplies. Then look at the price.

By Tyler Chin, AMNews staff. Jan. 13, 2003.

Since 1994, Nancy Orchard, MD, has used and discarded three electronic medical records software products, seeking to find a "cheap" or "economically feasible" EMR that would give her better and quicker access to patient information.

With each move, the solo ob-gyn in Yuba City, Calif., bought an EMR that cost less than its predecessor, going from $6,000 to $1,750 to $1,000.

"The most expensive was the worst and by far the cheapest was the best," Dr. Orchard said. Still, she stopped using the latter because it would freeze her computer, forcing her to reboot every computer on the network.

Like Dr. Orchard, many solo and small practice doctors can't afford to drop tens of thousands of dollars on higher-end systems. They are looking to buy an EMR as cheaply as they can, raising the question of whether cheap systems can deliver what doctors want out of them. The answer is: maybe. To make sure they get a system that can deliver the goods, doctors have to be clear about what they need and must be realistic about what they get. And what works for one of your colleagues may not work for you.

"I think doctors expect a lot, and I think they are beginning to learn that no small software company, probably not even bigger ones, can meet all their needs," said David Kibbe, MD, director of health information technology at the American Academy of Family Physicians. "Doctors' expectations are highly variable, for one thing. One area where physicians' expectations vary most is in terms of work flow."