Friends Don't Let Friends Build EMRs

Gregg Grubb has a cautionary tale for practices to get to know their technology vendor before jumping into a costly relationship. His story is also a prime example of why it's best not to do business with friends. Or friends of one's partner's husband.

Back in May 2004, Grubb and his partner chose what they thought was a reliable vendor for an EMR and practice management system. "He told us he had been in business for 17 years, and there were many clinics he was working with," Grubb recalls. But when the pieces of the system started coming together, it became clear that Grubb's Chicago-area practice, AIM Immediate Care Center, was the first occupational/urgent care center in the vendor's book of business. "None of it made sense for what we were doing. It was all [for a] family practice. It was a square peg for a round hole," he says.

Strike one.

Another try

Not wanting to lose too much ground, the physicians immediately went looking for a new vendor. "My partner's husband wanted us to [work with] his colleague -- a PhD in computer science with lots of credentials. He had written programs for some major hospitals," says Grubb.

So Grubb sketched out his vision for a paperless office: Patients would call in or walk in; their demographics would be collected, their chief complaint recorded. Then, says Grubb, "The protocol sheet for their chief complaint would pop up on my tablet. I would fill it out, the nurse would fill out her portion, and there would be drop-down boxes for diagnoses and patient education. Based on what [was] checked off, paper would be generated for take-home sheets. The diagnosis and E&M codes would be generated by the computer, and with another push of a button, the entire chart and the charge ticket would be e-mailed to the business office."

Not a problem, says the ersatz expert. "He wrote the prototypes and it flowed exactly the way I wanted it to," says Grubb. With a handshake, the deal was on.

Six months passed.

"Nothing progressed. It worked prototypically, but nothing linked together," Grubb explains. His vision for a paperless office appeared more distant than ever. Paper charts and snail mail were still the norm and, in fact, were needed to supplement what little the practice could do electronically. Productivity was down the drain, and staff were forced to take paperwork home over the weekend to keep up. The computer guy, it seemed, was too busy working on projects promised to Fortune 500 companies (with whom he had written contracts). "He was just doing ours on the side," Grubb says.

It was beginning to smell like a raw deal to Grubb. "So we had four or five other vendors review his work to see if they had a better mousetrap. What they found was a lot of the software had been pirated and that a lot of what he told us were his original ideas had been taken from other people's Web sites. He hacked into other vendor's databases and tried to piecemeal it together."

Strike two.

Finally, satisfaction

Grubb and his partner confronted their tech man, who denied the accusations (are you surprised?), and who followed up by sending the practice an invoice for $10,000 -- "on top of the $28,000 we had already paid him," says Grubb. At the end of his rope, Grubb called the attorney general and filed a report on Microsoft's fraud line.

He then placed a call to the vendor's biller -- who happened to be his wife -- and told her the story. "She was embarrassed," says Grubb. "She told me, 'It sounds like we need to refund you instead of bill you.' But we weren't looking for that -- we wanted it to be a wash -- and that's what happened."

Happily, Grubb was able to get the kind of system he wanted from one of the vendors who helped uncover the shaky deal. "It has been a blessing. [The system is] working exactly the way I want it to."

As for advice for practices contemplating major technology purchases -- Grubb has some, and it's pretty simple: "Do your homework. Find out who's reputable. And don't go with someone who doesn't have as much passion for getting the job done as you do."

Otherwise, you're bound to strike out.

This article originally appeared in the September 2005 issue of Physicians Practice.