WalMart eClinicalWorks Dell Not Quite All There

WalMart's promise to target small physician practices by offering what seems to be plug-and-play software by eClinicalWorks, supported by Dell computers finally puts EMR software much more into the mainstream. WalMart's recently branded slogan, Live Better, Save Money, speaks to the company's heightened mission to participate in reducing health care costs. But, having tracked prices, services, and implementation successes of EMR companies since 2003, we have never seen eClinicalWorks offer an EMR for more than $15,000 for the first physician, so I question the benevolence of $25,000 for the first MD.

Of more concern is the offer of an off-the-shelf integrated EMR/practice management system. To fully use this offer, a physician group will need to boot its current practice management system, a plan that puts the practice's financial stability at risk without a well thought-out data migration plan. In general, I have admired eClinicalWorks' installation staff -- they are some of the industry's best, so perhaps they have thought this through and are holding back details about how they will manage the technical complexity of a full blown implementation. Perhaps WalMart can redesign the eCW package to include a timeline detailing the physician's tasks before, during, and after go live..tasks that vendors, even the best, cannot manage. Download ASCO's EHR Field Guide to get a glimpse of what should be on that timeline.

For oncology, the WalMart deal comes on the heels of a successful launch of ePrescribing incentives, ARRA stimulus incentives, and HealthVault's announcement that it also has a relationship with WalMart. Watch for a more aggressive push for personal health records and health information exchanges in 2009 EHR activities. Also, watch for greater clarity on the WalMart-eCW-Dell deal because it will take more than shelf space at Sams to make this a go. I hope it sets the stage for many more big box collaborations.