Top EHR Adoption Challenges for Small Clinics

Posted by: Aparna Prasad

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EHR adoption challenges for small clinics

A small clinic faces several challenges in the quest to purchase and implement an EHR, and then qualify for the incentive payments from CMS (referred to as Meaningful Use).

The most overwhelming issue being faced by these practices is that the deadline for beginning the process of proving an EHR for Meaningful Use is 2012. Ninety days of data collection are required in the first year which means that October 1, 2012 was the deadline for starting the data collection process. If a small clinic is not already running a certified EHR, there is no chance that it can meet the requirements necessary to collect the maximum incentive payment.

Reduction in Medicare payments will start in 2015

If a certified EHR is not implemented by 2015, reductions in the clinic's Medicare payments will begin. In 2015, the reduction is 1 percent; the reduction is 2 percent for 2016 and 2017 has a 3 percent reduction.

There are numerous technical and financial challenges being faced by small clinics and independent physician groups who are trying to qualify to receive the Meaningful Use incentive payments.


For your clinic to make an informed decision there must be a shared vision among all your stakeholders. Widespread support is necessary to successfully implement and sustain an EHR system. By planning ahead, there will be fewer surprises during the actual implementation process.

Financial challenges

The average cost for a primary care practice or small clinic (with five physicians) is approximately $162,000 with a monthly maintenance cost of about $7,000.

Most small clinics do not have the cash they need to meet the upfront costs of an EHR system. Just attempting to calculate the total cost of the system is another issue that small clinics are dealing with. For an EHR system to work the necessary resources must be available to support it. If the support is not there, a return on this investment is unlikely.

Reluctance to adapt/culture

When switching from the traditional methods, all your personnel must improve their technology skills. Their workflows will have to change and they will need to modify their tasks to be used with the new system.

Limited time for training

Another one of the EMR adoption challenges for small clinics is not having the time necessary to deploy a system. Adequately training your personnel to use this technology is an essential aspect of implementing this type of system but training takes time that many small clinics do not have. Research has shown that when personnel receive sufficient training on these systems, they are more satisfied and show better progress than those who do not.

Data migration

Moving information from one system to another could mean data loss. Whether your clinic is moving from another digital system or paper-based system is irrelevant, this task is time consuming. However, you can help this process move along quicker if you only move the information that is critical to each patient’s treatment as they move forward.


If your small clinic is planning to use the EHR in addition to other IT systems, there have been some difficulties in this area. Trying to get the different systems to communicate with one another is a challenge.

Vendor availability

Because of the expiration date to receive incentives, many small clinics and physician’s offices are in a rush to get their EHR systems in place. This means that inexperienced personnel are struggling to keep up with the demands and providers are not receiving the support they need. Many small clinics and practices have decided to hire regional extension centers and EHR consultants to assist them in filling these gaps.

These challenges are very real, but with proper planning, training, implementation and execution, there is no reason why a small clinic can't benefit from an EHR. Read one of our blogs about selecting an EHR here, or read our Ultimate EMR Implementation Guide.



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Topics: EMR for Small and Solo Practices

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