To the Editor:

My partner and I appreciated Dr. Schenk’s letter in your April 2001 issue [“The Other Side of the EMR Story”]. We both experienced a less-than-favorable introduction to electronic medical records (EMRs), and this was a major factor in causing us to break with our group.

We were part of a 20-physician group with four different sites. The group began using an EMR with all the bells and whistles – daily visit records, billing by physicians at the time of event, scheduling, prescription writing, messaging. You name it, it had it. Unfortunately, almost 1½ years after implementation, the system still hadn’t lived up to its promise. It crashed frequently – to the point that the group and EMR vendor now share the expense of keeping a troubleshooter on-site to take care of daily computer problems.

I have some suggestions for future EMR buyers:

• Decide what part of the EMR you want to start with (e.g., just the prescription portion). Familiarize yourself with each part before moving on to the next, and make sure all members of the staff are on board.

• Insist that the vendor provide decent training. Many of the trainers we had did not have the patience or ability to translate their advanced knowledge into simpler terms.

• Don’t expect all group members to be equally enthusiastic at the beginning. Let those who are eager and familiar with computers be the first to use the EMR system, and then allow others to join in at their pace (this could take one to two years depending on the characteristics of the group). Be prepared to have dual systems of recording patient visits until everyone is comfortable with the EMR system.

• Get the billing system working first. Physicians don’t want to lose revenue because the computer wasn’t set up properly.

We will eventually use an EMR system again; it has distinct advantages over bulky records. But we won’t be tripped up again by glib sales talk.