Guerra On Healthcare: Cutting Ties With An EMR Vendor

If you find yourself in the unenviable position of breaking up with your electronic medical record provider, honesty, forthrightness, and transparency go a long way.
Most of the time, there's a tighter correlation between big bucks and big responsibility, than big bucks and long, grinding hours of toil. Most of the time, big shots make oodles of cash for getting a few grand, strategic decisions right, rather than being personally involved with countless little ones.

Equally true is the fact that you aren't being paid to handle 95% of the common situations that confront you every day, rather the remaining extraordinary challenges that bring to bear your years of experience, analytical abilities, and managerial prowess during a crisis, when relatively fast decisions must be made, then efficiently operationalized. (Think of that dreaded call during the night from your help desk communicating that the network is down and all your applications are dead in the water. Oh, and this just happens to be the week after you've finally completed your "Paper be gone!" campaign. Oh, why did you let them put your picture on the internal marketing collateral?!?)

The extraordinary situation I'm thinking of today is one I've been hearing about more and more during my CIO interviews -- vendor dis-engagement. A marriage is a big party, but divorce can be hell. Before lawyering up, most agree it's best to look inward at why the marriage failed, lest the relationship with wife number two amount to a reprise of the first. But when "irreconcilable differences" necessitate a split, there are some best practices which can be followed to ease the transition.

If you've ever seen the movie "The War of the Roses" with Michael Douglas and Kathleen Turner, you may remember a scene during which Danny DeVito (Douglas' divorce lawyer) urges another of his clients to go back to his wife and try to make it work. If it can't work, DeVito says, give until it hurts, give everything, and then give some more. Be as generous as you can humanly be, because the alternative is an all-out, ugly, and nasty battle, the likes of which you cannot possibly imagine.

While the CIOs I've spoken with who have (or are currently) navigating a vendor divorce haven't gotten that far, their best practices echo what lies at the core of DeVito's message -- be understanding of what the other side is going through, be kind, respectful, courteous, and, above all, honest, forthright, and transparent. Communicate the impending separation as early as possible, lest they hear it through the grapevine or (worse) read it on the Internet. Though you don't have to, honestly (though firmly) tell the other party why you need to split. Often, their initial anger or disappointment will morph into understanding and appreciation over time.

Another tenet at the core of successful parting is the age old adage, "Don't burn your bridges." While every industry seems small to those ensconced in it, healthcare IT is a small world. With LinkedIn, the College of Healthcare Information Management Executives (CHIME), and the Healthcare Information and Management Systems Society (HIMSS), it'd be shocking if you didn't connect with everyone in this industry by, at most, two degrees of separation. Indeed, the inpatient electronic medical record (EMR) vendor community is close to microscopic. With seven big players, it's likely you'd run into a departing incumbent again should you switch jobs. People who've been confronted with unpleasant news in a professional manner remember it for a long time, but those who've been handled roughly will remember you forever.

Vendor dis-engagement, just like terminating a problem employee, is one of the situations you are being paid to handle, and handle well. Apply the principles and ethics that will make you successful in any situation, and they will serve you equally well here. And don't despair, because with firing comes hiring, so as you say goodbye to the incumbent with compassion, you can look forward to welcoming the partner with exuberance.

Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at [email protected].