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Wal-Mart, eClinicalWorks Deal Exposes Need For EMR Price Transparency

Kathryn Mackenzie, for HealthLeaders Media, March 17, 2009

The big health information news is that Wal-Mart's Sam's Club is partnering up with electronic medical record vendor eClinicalWorks and Dell Inc. to sell electronic medical records to physicians.

Sam's Club will offer the package this spring starting at under $25,000 for the first physician in a practice and $10,000 for each additional doctor. Ongoing costs will be $4,000 to $6,500 per year.

The package will include a Dell desktop or tablet PC installed by Dell technicians and software-as-a-service applications from eClinicalWorks. The price also includes five days onsite training by eClinicalWorks technicians.

The reaction to the news of an "EMR-in-a-box" has been remarkable. From the New York Times to a plethora of tech blogs, everybody is talking about what has been called a potential game changer for the EMR market.

"If they can sell these systems and deploy them effectively, it could completely change the structure of the market. I'm sure there's a tremendous amount of nervousness about this in the industry, but this is one of those things that once somebody does it, it's going to be very difficult for others not to follow suit," says David Brailer, MD, former national coordinator for health information technology in the Bush administration and current chairman of healthcare investment company, Health Evolution Partners.

Changing the structure of the EMR market is exactly what eClinicalWorks' President Girish Kumar Navani has in mind. "For too long the EMR has been treated as a niche product. Doctors are told that it takes a year to implement and costs hundreds of thousands of dollars and makes for a very painful experience. The reality is that it doesn't take that long and it doesn't cost that much," says Navani.

Navani says this strategy will remove some of the confusion related to buying an EMR because there will be one set price for the product, with haggling and add-ons taken completely out of the equation.

"Sometimes I'll hear of a small doctor's office that spent $250,000 buying an EMR. I'm left asking, 'How did you get so ripped off?' What happens in our industry is people come up with whatever pricing works. I have seen vendors charge one price for a cardiologist's practice and another for a primary care physician—for the same software. That is unbelievably unethical," says Navani.

One of the main criticisms of EMRs being sold at a retailer is the idea that a doctor can saunter into Sam's, grab some groceries, pick up a prescription, and, oh yeah, might as well buy that EMR too.

That's not how it's going to work.

In actuality, the EMR bundles will not even sold in Sam's stores. "It's something that's going to have an online presence on samsclub.com. The order process will take anywhere from 10 to 12 weeks because there are going to be a series of steps to analyze the practice and determine what the specific practice needs are," says Susan Koehler, senior manager of corporate communications at Sam's Club.

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