The Wheat from the Chaff or How do I decide on an EMR?

There are abundant promotional references about EMRs (electronic medical or health records). Deciding the truth from the embellishment or the facts from fiction should not require a Ph.D. But a recent Google search produced numerous ratings from a variety of sources scuh as KLAS, Black Book, Vendors, Consultants, and AMA. Who can we trust?

Unfortunately, industry analysts, the neutral arbiters of truth in high technology, have tarnished their own image by their need for analyses by any number of vendors. With the customer footing the bill, it is no small wonder that negative analysis results will not likely see the light of day; but positives will.
Some key players include KLAS, a private organization (, Black Book Rankings (http://, and The Health Technology Review ( Numerous other reviewers participate as part of professional consultants, professional service components of vendors and independent consultants. While these key players may be believable because of their relative independence, sole reliance on their findings will not satisfy due diligence.

To benefit from any review or independent consultant, an iterative process may be necessary where a buyer will state broad requirements and vendors may refine or focus them. This may seem too deliberate for some buyers, but often this helps buyers identify vendors who will value relationships. These relationships are essential because of the broad spectrum of possibilities in EMRs that may exceed the organic capabilities of the customer. Thus assistance from vendors or consultants may not only be helpful but needed.

Also helpful to buyers are current owners or users of any software. These users may have similar environments and requirements of the buyer and shared experiences, concerns and expectations may facilitate decision making. But alas, the parallels only hold true if the circumstances and the medical specialties are similar. In medicine, specialties are sufficiently dissimilar to make broad generalizations perilous.

However, there are no shortcuts in the purchase process. No consultant or reviewer can shorten that process. Responsibility still rests with the prospective buyer and any decision on any vendor or any product is theirs and no one else.


Richard Hom is a EMR advocate and public policy consultant who has been a product and marketing manager for six software products. His blend of direct patient care and technology know how brings pragmatism to technology in health care.

Linda Stotsky is both a hands-on health information technology (HIT) consultant and a product man-ager who has extensive experience in matching customers to solutions. Her command of the complete value chain of HIT is deep and her able skill in vertical and horizontal communications is well-known.

About Richard Hom OD, MPA

Dr. Hom holds Doctor of Optometry and Masters in Public Administration degrees and practices family eye care and consults on public policy, health information technology and program evaluation.
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