I've recently written about Wal-mart's effort to reduce the cost of EHR acquisition. Many folks have asked for more details about how the product will be promoted and sold. Here's the answer based on followup calls with the Wal-mart folks running the project.
Sam's Club currently has "feet on the street" visiting with small business operators. In particular, there are individuals from the Health and Wellness business group that are currently calling on physician members. In the past, they would have spoken to physicians about the $4 Pharmacy program and office supplies. That same group will also be used to promote the EHR Solution. However, that is not enough to spread the word.
In partnering with eClinicalWorks and Dell, Sam's Club will be leveraging their "feet on the street" to get out the message. Sam's will rely on eClinicalWorks to communicate the technical details of how the software product works. ECW will do all the demos. Sam's is working with them to streamline that demo process. A first step is to do a web-demo which is relatively low cost.
Sam's is also beginning the process to partner with state governmental organizations and professional organizations to communicate the value of the program. Those partnerships will also spread the word.
Sam's will eventually create traveling demos so that physicians can be invited to clubs for a more interactive event targeted to their needs.
Per Sam's, all of this may not be enough. Depending on the pace of demand, they may also leverage existing infrastructure from other organizations to get the word out.
So, in summary, you'll not find a doctor at Sam's getting a case of toilet paper and an EHR, you'll find one on one discussion, demonstrations, and the involvement of many professional groups. Just as with the rollout and support, Sam's seems to have really thought this out.
Tuesday, April 14, 2009
A Followup on Wal-Mart's EHR effort
Posted by John Halamka at 3:00 AM
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Given Wal-mart's entry into healthcare services, do you think it's time that physicians began selling medications?
For some reason physicians are not allowed to sell a wide range of medications and potentially health related devices.
I think there's a law against that, but I'm sure there was never a good reason for such a law ...
Wal-Mart is going after more than just the EHR, they are adding clinics into their local "Super Centers" in select areas now. The health system I work for has partnered with them, it's an interesting model.
A more complex component beyond the marketing of the service is how will ECW be implemented within the practice. Who will have responsibility for the integration of existing health records, configuration of the SAAS instance at ECW, changes to the business processes of the practice, interconnection to claims processing, cyber security of the physician's office assets and interconnectivity with HIE services beyond the ECW connection. This is where most of the post-sales "hidden" costs are incurred. Another key element is what costs are reimbursable under CMS' ARRA funded program.
Walmart's entry in to the EHR market is a truly interesting development. In doing so, I think a false hope of a "cheap and easy" EHR implementation is presented to the smaller medical practices.
The costs of hardware and software are only the start. Integration of the health records and other electronic applications and workflow development need to be planned for (as pointed out in the comment above).
The practice will also need to implement and maintain a secure and robust computer network to ensure their now mission-critical application and data is safe and available- a big step beyond what they are probably already doing.
All of these costs shouldn't be "hidden" - Will Walmart and ECW be responsible about setting expectations? I've seen staff members at smaller practices fight back tears as they described how hard it was to get their EHR program running.
As eager markets jump on the EMR bandwagon, this spreads the impact on who will be affected by HIT standards. My curiosity lies with early adopters' risk with the ICD-10 "Big Bang" on the horizon. I wonder if these resources, via taxpaxer-funded grants and by institions, will be at risk in October of 2013? And, could or should the ARRA now consider/include ICD-10 in their timeline and incentives?
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