Have Best-Of-Breed EMRs Lost The Hospital Battle?

Is a best-of-breed or enterprise/single vendor EMR implementation the best approach for your hospital? This topic has been the focus of much debate ever since EMR software came into existence, and both sides have compelling arguments. At a high-level, a best-of-breed approach to EMR implementation typically offers a greater level of functionality for specific specialties or departments. However, integrating disparate best-of-breed EMR systems within a facility can be a challenging and expensive undertaking. An enterprise (or single vendor approach), on the other hand, offers complete data integration out of the box (which is also expensive). However, an enterprise EMR often forces hospitals to sacrifice functionality in specific departmental applications.

Prior to Meaningful Use, I’d argue that most hospitals in the U.S. that had adopted some form of EMR opted (sometimes unknowingly) for a best-of-breed approach. At the very least, best-of-breed EMRs ran neck-and-neck with enterprise deployments. I say this because, more often than not, EMRs were installed to address specific departmental or facility needs prior to 2009. There wasn’t a nationwide push at the time to establish a universal electronic health record. If advantages could be realized by installing an EMR solution in the ER or cardiology wing, a system was installed in those departments and not in others, often without much regard to whether or not the two systems could “talk to one another.”