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Terry McLeod of ehrSIO ProjectsehrSIO Projects
A blog about the technical and software sides of mental health and addictions

Negotiations: Implementing an Electronic Health Record (EHR) System

Terry McLeod Updated: Mar 15th 2011

How much does it cost?

We have a tendency to move in that direction when we first start investigating a purchase. Unfortunately, the cost of a thing doesn't necessarily tell us anything about its value. So, whether I'm buying an egg or an Electronic Health Record (EHR), I need to divert my thinking from cost to what I get out of it. I have to watch my cholesterol, so I watch the eggs, and when I help agencies buy EHR's, I look for comparative benefits to the consumer and professional.

hand stacking moneyThere are tons of books out there on negotiating (just Google it), and if you're making a large purchase, from a car to an EHR, and it's not a bad idea to know a salesperson's perspective before going into negotiations. I found Roger Dawson's book an easy read and illuminating for that purpose.

The EHR purchase affects both consumers & professionals because the facility always needs to purchase more outside services & schedule training, f/u with all staff to assure they're using system and using it right in order to get the value out of the system.

The consumer feels the effects of an EHR when service is disrupted due to lack of training, or because a form that's supposed to speed an intake doesn't work right and it just takes too much time to finish the paperwork…or worse, a problem leaves the consumer in the waiting room, without the help he's asking for. These troubles can usually be avoided during implementation if the agency is wise in not cutting corners on services to implement the system. Earned wisdom includes hiring or assigning a full-time, experienced internal person to tend to agency business and assure the consumer experience is not disrupted.

The real negotiating point for the price software is the license. Most companies that sell software are manufacturers, so the cost of the building the software has been reconciled by selling enough system licenses to pay for that cost. If this is not the case, you may want to re-think the company you are working with from the angle of experience and that earned wisdom I mentioned above.

In this sector a ton of companies manufacturing EHRs (84 good ones started in my last search process for a customer). Many were born at a mental health facility as a home-grown system. They're probably fine, provided the company has spun off from the original agency. If a company can't stand on its own two feet and keeps going back to the mother company to meet payroll, they may not be around long. It really makes people grouchy when their helpful software people just disappear one day. Agencies buying software need to be conscious of this.

Implementation services like importing existing data into the new system, configuration, training and fine tuning are really no place to cut corners. It always seems staff needs more help, and when they can't get it because the facility didn't pay for it, they get can get grouchy. In addition to the original problem of making the software work right, consumers feel this, simply because the EHR is part of their treatment experience. When a consumer needs help, the last thing he wants to run into is resistance due to software or user problems when somebody has offered to help them in the first place; It's a no-win situation. A good negotiating point is to plan to add optional services, they will likely be needed.

An agency also needs to pay attention to things like the HITECH Act, the software support reputation (call a bundle of references, not just their preferred customers), and their internal experts available to successfully implement the software.

My jaded and self-interested advice is to hire a professional. A good consultant can counsel the entire staff, bottom to top on how to get a product that proves to be a good value: An EHR that improves the consumer experience, satisfies documentation requirements, improves the quality of the agency and doesn't make people grouchy and defeat the purpose of mental health improvement.


Terry McLeod

Electronic Health Records (EHRs) are a required part of our society, and improving business workflows with the EHR is imperative for the survival of your local mental health and addictions treatment clinics. Terry McLeod provides the bridge between the mental health and addictions professional and the technical world, as well as the glue to keep it working. Contact McLeod at and get more information from his website and blog,

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