Box Store's EHR System Targets Small Practices

The big box store Sam's Club is setting its sights on the information technology frontier by marketing electronic health record systems for medical practices with one to three physicians.

But not everyone is sold on value of such off-the-shelf systems, and with EHR systems seen as essential to health care reform and the ability to control spending, a lot is riding on just how these products are used in clinical practice.

With the package offered by Sam's Club, a Wal-Mart subsidiary, practices will receive three laptops and a tablet notebook from Dell, a laser printer, and EHR and practice management software from eClinicalWorks. The package, which also includes 12 weeks of on-site setup, customization, and support, costs less than $25,000 for the first physician and up to $10,000 for each additional physician in the practice. Available for purchase online, the package is being sold only to physicians in Georgia, Illinois, and Virginia, with a nationwide rollout planned for later this year.

The plan to sell the EHR system to Sam's Club members grew out of Wal-Mart's successful experience using Dell and eClinical Works EHR systems at its walk-in medical RediClinics. “We have 200,000 medical-type [business members] at our 600 clubs nationwide,” said Susan Koehler, senior manager in corporate communications at the Sam's Club home office in Bentonville, Ark.

Unlike Wal-Mart, Sam's Club has a one-on-one relationship with local businesses that buy supplies at the club, “so we have relationships at the local level with those doctors,” Ms. Koehler said.

Georgia, Illinois, and Virginia were selected for the rollout because “they were a good representation of broad-band access with a mix of rural and small-town community doctors,” she said. Those states also include big cities such as Atlanta and Chicago.

Ms. Koehler would not say how many systems have been sold since the product's launch in early April, but “we're very pleased with the interest” in it, she said.

With discounted hardware from Dell and savings from “interfaces coming out of the box,” Sam's Club could price its EHR system aggressively, explained Girish Navani, cofounder and CEO of eClinicalWorks in Westborough, Mass.

The package does not offer any less customization than if a physician practice was to buy a system individually, Mr. Navani said. “We don't change our implementation process.”

Dr. Michael Woolery, who practices in Coshocton, Ohio, recently bought an EHR system from another vendor, and said he would be wary of an off-the-shelf system. “You really need to spend a lot of time investigating different vendors and looking at different features that vendors can offer,” he said. “It takes a significant amount of time to pick a system and do that conversion and put the data you have already into a new format.”

Dr. Steven Waldren, director of the Center for Health Information Technology at the American Academy of Family Physicians, said that packages like Sam's Club's have advantages and disadvantages. “It's really a product and service package, not [just] a box of software that you order and then get installed,” he noted, yet the disadvantage is that it is prepackaged, “so decisions are made for you when they put it together.”

Workflow is a key factor in EHR selection, Dr. Waldren said. “Does it have the templates you need and want?” If you have midlevel personnel, “how does the signoff process work?” If the workflow “doesn't work for you, what type of customization is possible?” Off-the-shelf systems will cost less, “but there are probably going to be disadvantages around customization and the flexibility practices are going to have,” he said.

Although the package is aggressively priced, it is designed to be customized. MR. NAVANI

The big box store Sam's Club is setting its sights on the information technology frontier by marketing electronic health record systems for medical practices with one to three physicians.

But not everyone is sold on value of such off-the-shelf systems, and with EHR systems seen as essential to health care reform and the ability to control spending, a lot is riding on just how these products are used in clinical practice.

With the package offered by Sam's Club, a Wal-Mart subsidiary, practices will receive three laptops and a tablet notebook from Dell, a laser printer, and EHR and practice management software from eClinicalWorks. The package, which also includes 12 weeks of on-site setup, customization, and support, costs less than $25,000 for the first physician and up to $10,000 for each additional physician in the practice. Available for purchase online, the package is being sold only to physicians in Georgia, Illinois, and Virginia, with a nationwide rollout planned for later this year.

The plan to sell the EHR system to Sam's Club members grew out of Wal-Mart's successful experience using Dell and eClinical Works EHR systems at its walk-in medical RediClinics. “We have 200,000 medical-type [business members] at our 600 clubs nationwide,” said Susan Koehler, senior manager in corporate communications at the Sam's Club home office in Bentonville, Ark.

Unlike Wal-Mart, Sam's Club has a one-on-one relationship with local businesses that buy supplies at the club, “so we have relationships at the local level with those doctors,” Ms. Koehler said.

Georgia, Illinois, and Virginia were selected for the rollout because “they were a good representation of broad-band access with a mix of rural and small-town community doctors,” she said. Those states also include big cities such as Atlanta and Chicago.

Ms. Koehler would not say how many systems have been sold since the product's launch in early April, but “we're very pleased with the interest” in it, she said.

With discounted hardware from Dell and savings from “interfaces coming out of the box,” Sam's Club could price its EHR system aggressively, explained Girish Navani, cofounder and CEO of eClinicalWorks in Westborough, Mass.

The package does not offer any less customization than if a physician practice was to buy a system individually, Mr. Navani said. “We don't change our implementation process.”

Dr. Michael Woolery, who practices in Coshocton, Ohio, recently bought an EHR system from another vendor, and said he would be wary of an off-the-shelf system. “You really need to spend a lot of time investigating different vendors and looking at different features that vendors can offer,” he said. “It takes a significant amount of time to pick a system and do that conversion and put the data you have already into a new format.”

Dr. Steven Waldren, director of the Center for Health Information Technology at the American Academy of Family Physicians, said that packages like Sam's Club's have advantages and disadvantages. “It's really a product and service package, not [just] a box of software that you order and then get installed,” he noted, yet the disadvantage is that it is prepackaged, “so decisions are made for you when they put it together.”

Workflow is a key factor in EHR selection, Dr. Waldren said. “Does it have the templates you need and want?” If you have midlevel personnel, “how does the signoff process work?” If the workflow “doesn't work for you, what type of customization is possible?” Off-the-shelf systems will cost less, “but there are probably going to be disadvantages around customization and the flexibility practices are going to have,” he said.

Although the package is aggressively priced, it is designed to be customized. MR. NAVANI

The big box store Sam's Club is setting its sights on the information technology frontier by marketing electronic health record systems for medical practices with one to three physicians.

But not everyone is sold on value of such off-the-shelf systems, and with EHR systems seen as essential to health care reform and the ability to control spending, a lot is riding on just how these products are used in clinical practice.

With the package offered by Sam's Club, a Wal-Mart subsidiary, practices will receive three laptops and a tablet notebook from Dell, a laser printer, and EHR and practice management software from eClinicalWorks. The package, which also includes 12 weeks of on-site setup, customization, and support, costs less than $25,000 for the first physician and up to $10,000 for each additional physician in the practice. Available for purchase online, the package is being sold only to physicians in Georgia, Illinois, and Virginia, with a nationwide rollout planned for later this year.

The plan to sell the EHR system to Sam's Club members grew out of Wal-Mart's successful experience using Dell and eClinical Works EHR systems at its walk-in medical RediClinics. “We have 200,000 medical-type [business members] at our 600 clubs nationwide,” said Susan Koehler, senior manager in corporate communications at the Sam's Club home office in Bentonville, Ark.

Unlike Wal-Mart, Sam's Club has a one-on-one relationship with local businesses that buy supplies at the club, “so we have relationships at the local level with those doctors,” Ms. Koehler said.

Georgia, Illinois, and Virginia were selected for the rollout because “they were a good representation of broad-band access with a mix of rural and small-town community doctors,” she said. Those states also include big cities such as Atlanta and Chicago.

Ms. Koehler would not say how many systems have been sold since the product's launch in early April, but “we're very pleased with the interest” in it, she said.

With discounted hardware from Dell and savings from “interfaces coming out of the box,” Sam's Club could price its EHR system aggressively, explained Girish Navani, cofounder and CEO of eClinicalWorks in Westborough, Mass.

The package does not offer any less customization than if a physician practice was to buy a system individually, Mr. Navani said. “We don't change our implementation process.”

Dr. Michael Woolery, who practices in Coshocton, Ohio, recently bought an EHR system from another vendor, and said he would be wary of an off-the-shelf system. “You really need to spend a lot of time investigating different vendors and looking at different features that vendors can offer,” he said. “It takes a significant amount of time to pick a system and do that conversion and put the data you have already into a new format.”

Dr. Steven Waldren, director of the Center for Health Information Technology at the American Academy of Family Physicians, said that packages like Sam's Club's have advantages and disadvantages. “It's really a product and service package, not [just] a box of software that you order and then get installed,” he noted, yet the disadvantage is that it is prepackaged, “so decisions are made for you when they put it together.”

Workflow is a key factor in EHR selection, Dr. Waldren said. “Does it have the templates you need and want?” If you have midlevel personnel, “how does the signoff process work?” If the workflow “doesn't work for you, what type of customization is possible?” Off-the-shelf systems will cost less, “but there are probably going to be disadvantages around customization and the flexibility practices are going to have,” he said.

Although the package is aggressively priced, it is designed to be customized. MR. NAVANI