Many people have written about EMR failures. Blaming happens at many levels:

• Poor Software
• Bad Vendor
• Inadequate implementation
• Inferior technology
• Deficient Training
• Lack of drive and motivation within a practice
• Practice adopting EMR for the wrong reasons
• Staff just not ready
• … list can go on…

I have heard so many reasons, it almost feels like ‘excuses’. I could not understand why the same software and same vendor was successful with some practices (I should say most practices) whereas others fail? 

What was common between those string of failures, irrespective of the vendor? I decided to meet those practices. My conversations started with the usual suspects; the list above. As I kept probing something interesting started emerging. Let me start with some of the behind-the-scenes reasons.

• Staff felt threatened
• Preservation of prior processes that worked, but not well enough
• Staff feel that the system slowed them down
• Old system was easier

You perhaps see where this is going. The practice Owner/Provider did not see it coming, did not see the signs and signals.

Single reason for EMR Failure – Lack of Leadership

Leadership is to enable. Providers failed to realize their decision was being undermined. All the reasons sited above point to a single factor that staff really questioned the provider’s decision, which was being held hostage.

Most providers realized this after we engaged in an extensive discussion but it was too late. Leaders need to stand up and make a point – I/We have decided to ‘change’ for better. There will be short term pain, but you are going to go along or the practice goes along without you.