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

Enterprise Software and the Electronic Health Record

Terry McLeod Updated: Jul 19th 2011

A post on Linked In shared a consultant's opinion that enterprise software breeds evil.

networked computersWell, now, that's just nonsense. Enterprise software is designed for an agency, in my interest an Electronic Health Record (EHR) for mental health or substance abuse treatment organization, and the software helps people get their jobs done, meet regulatory requirements, assure billing gets done so everybody gets paid, and another very important thing. It may be tempting to rely on memory of a case record rather than go to the chart room to review the consumer's chart prior to a session. That can be not-so-good; the EHR eliminates trips to the chart room to see previous assessments, progress notes and treatment plans, conceivably bringing a more educated professional into a session and improving the consumer's likelihood of getting better.

Where does this perception of enterprise software's evils originate? If I rely purely on anecdotal information, it comes from the customer's experience with poor implementations. I've implemented, been cursorily involved with, and heard of a few EHR implementations, where not every person on the team followed all the advice that ultimately has the professional/consumer relationship in mind. And that shortcoming includes both vendor and agency. Poor planning is the usual culprit.

Over the weekend I went to scenic Boston, MA and attended the NIATx/SAAS conference and was able to sit in on a couple consultants' sessions about implementing EHRs. I also talked with several vendors, and made an interesting discovery. The "middle tier" of software vendors has come of age. These are software companies that aren't so big that they're priced out of a medium-sized agency's market, or so small they can't support what they sell. I was particularly interested in the address by keynote speaker David Spong. Another speaker that held my attention was an old friend to substance abuse, H Westley Clark, the director of the Center for Substance Abuse Treatment (CSAT).

The consultant's sessions were interesting insomuch as the questions coming from the audience were the same questions professionals were asking fifteen years ago and before.

  • How do we pick a software company when there are over 100 vendors out there manufacturing EHRs?
  • Once we pick an enterprise system, how do we install the doggone software in less than a year and a half?
  • How do we get professionals to use the system (some are pretty resistant)?

The vendors I talked with in the display area were cordial, very nice guys. I wanted some information that's key to my business, as it had been a year since I'd updated my records on these vendors. I asked some simple questions, including:

  • How long have you survived in this tough business?
  • How many customers do you have, in how many states?
  • Is your software certified to meet Meaningful Use requirements?

There were more questions, and I plan to address these industry concerns in upcoming posts. Who knows, I may even include some actual information on how to avoid implementation pitfalls and make the experience transparent to consumers…techie consumers are likely to be the only ones interested in this, but for professionals, I think it's a good subject. I'm thinking about a few reviews of vendors, and sharing my process for narrowing the field of vendors to a manageable few that can be included in a software search.

All in all, the NIATx/SAAS event is a good experience, filled with people who actually care enough about the consumers to stay in business and serve them. I'll likely attend next time.

...and I software and vendors aren't evil.


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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