At InformationWeek Healthcare's recent virtual event, Electronic Health Records: Moving Beyond The Basics, Mark Wagner, senior research director for KLAS, a health IT advisory firm, shared the expectations of many healthcare providers looking to purchase an electronic health record system. One clinician's demands summed up the thoughts of many:

"I want a system that can be customized but that doesn't take an IT expert to do it. I want a system that meets meaningful use and has a PM [practice management] system to accompany it. I would love a system that meshes with our specialty without having to modify it too much. Lastly, I want an affordable system that keeps up with all the mandates pushed on our specialty and yet does not slow down our productivity."

In an ideal world, that system would exist, but there's the dream and then there's reality, Wagner says. And the reality is that compromises have to be made, especially in today's market where EHR vendors are so busy selling systems that they barely have time to support the ones they've installed, much less create a platform that meets all your needs.

[ For more background on e-prescribing tools, see 6 E-Prescribing Vendors To Watch. ]

There are more than 600 EHRs that are certified to meet the Centers for Medicare and Medicaid Services' Meaningful Use financial incentives. Finding the right vendor in this maze of confusing options requires an appreciation for these market conditions.

To begin with, there's a good chance the vendor you choose is going to say: We'll put you on our list and get back to you in eight months. Some vendors might be able to install the system immediately but then will move onto their 100 other customers, leaving you to fend for yourself with staff training and tech support. In this environment, expecting a vendor to provide the ideal system--that's fully customizable, effortlessly meets all the MU requirements, meshes with all your specialists' needs, is affordable, and doesn't affect staff productivity--isn't in the cards.

Vendor resources are stretched too thin to make that happen. And with accountable care and ICD 10 on the horizon, the need for sophisticated EHR systems will only escalate. How does a healthcare provider cope?

The most successful medical practices don't rely solely on their EHR vendors. They supplement the EHR vendor's resources with competent staff of their own, sometimes with the help of a third party, to fill the gaps, Wagner said.

And the most successful providers accept the fact that EHR implementation will inevitably affect physician productivity, at least at the onset. Be prepared for the hurricane.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)