There is a lot of discussion concerning which is the ‘best’ Electronic Health Record for any individual entity.  There are a variety of parameters which should be considered prior to embarking upon what will undoubtedly be one of the most important decisions in the life of a healthcare organization.

One of the most important issues is ‘Should I purchase an EMR designed for my specific specialty?’  We will attempt to address some of the pros and cons of each option.

If you are involved in a multi-specialty clinic I would strongly advise against purchasing multiple different EMRs, one for each specialty.  One of the major difficulties with this plan, and it may be all but insurmountable, is the interconnectivity between the various programs.  Yes, they may all be HL7 compatible, but you will find yourself in an almost endless quagmire of interfaces.

The question is a bit more difficult to answer if you practice in a single specialty environment.  There are a large number of specialty specific EMRs for a variety of specialists, including Oncology, Ophthalmology, Orthopedics, Cardiology, etc.  In this instance, if you have a very sophisticated workflow, often seen in larger single specialty medical groups, then a specialty specific EMR may be most appropriate.  I find that Oncologists, in particular, do well with EMRs designed specifically for their specialty.  This is, in part, because many of their workflow issues are entirely foreign to almost all other specialties. This would include, of course, dosing issues concerning their cancer curing pharmaceuticals. 

At the other end of the spectrum would be Internal Medicine and/or Family Practice.  Most ‘general’ EMRs are fully capable of handling most of the workflow and reporting issues found in those practices, and therefore a more general EMR would be most appropriate.

Cardiology, Ophthalmology and Orthopedics, and many others, fall somewhere in the middle.  If you find yourself using a substantial number of activities that are not performed by any other specialists, such as in office arthroscopy for Orthopedists, you’ll likely find generic EMRs to be lacking in functionality.  If, however, your office based practice is more standardized, by which I mean closer to the activities performed by other specialists, then the problems which may be associated with single specialty EMRs may not be worth encountering.

What are some of these problems?  First of all, many single specialty EMRs are provided by companies which are both small and unlikely to grow much larger because of their limited potential user base.  Certainly this is not the case of all single specialty EMRs, and there are some multi-billion dollar companies producing fine software in this arena.  However, many of them are products which were started by a physician in that specialty.  Their longevity in the marketplace must be considered when acquiring software of that nature.

So, in short summary, I would encourage you to take a careful look at the workflow in your office and consider how similar or different it is to other physicians of different specialties.  If it is not extraordinarily different, I would go with a more general EMR.  For your specific installation, that of a multi-specialty clinic, I would strongly recommend purchasing a general EMR from a company which is large enough to have developed the different workflows for each relevant specialty.