Sam's Club Offers Prepackaged EHR Systems

Physicians living in Virginia, Illinois and Georgia have a new online option when it comes to selecting an electronic health record, or EHR, system -- that is, if they are members of Sam's Club, a division of Wal-Mart Stores Inc., and are willing to consider a prepackaged assortment of products and services.

The offer is possible because of Wal-Mart's partnerships with e-ClinicalWorks, which provides software and services, and Dell, which handles hardware and system installation. An April 6 press release announced the launch of the offer, which Sam's Club calls a "turnkey" EHR package developed with small physician practices in mind.

The bundle of health IT goods and services starts at about $24,000 for one physician and includes hardware, software, installation, training, technical support and maintenance. Sam's Club claims physicians can save up to 50 percent on the cost of an EHR.

According to Kenji Gjovig, health care business development manager for Sam' Club, the offer will be available nationwide by the end of the year.

Gjovig was anxious to clear up confusion created by media reports that the EHR systems would be available for physicians to pick up at their local Sam's Club store. "We aren't selling them through our brick and mortar channel; it's an online relationship," said Gjovig. "There's a huge difference between buying Tide or Pampers and buying an EHR."

Instead of pushing a cart through a Sam's Club store, physicians can peruse the EHR offer online and then contact the companies involved for more details.

Although the Academy does not endorse any individual EHR product, Steven Waldren, M.D., director of the AAFP's Center for Health IT, said some physicians undoubtedly would appreciate the prepackaged concept.

"In a health IT market chock full of options, the product bundling eases the selection process for physicians," said Waldren. It also may lessen the disappointment and finger pointing that can occur when physicians realize after an EHR implementation that some hardware and software systems are more compatible than others are, he added.

In this case, the Dell computers included in the package have been tested on the e-ClinicalWorks application to ensure compatibility, said Gjovig.

Wal-Mart has been using EHRs in its retail health clinics nationwide since 2006. According to Gjovig, that experience led the company to appreciate the value EHRs and electronic prescribing bring to the health care table. "Here's a chance for us to sell technology to the marketplace that will enable more physicians to send prescriptions to us electronically, which lowers our cost," he said.

He added that the overall goal of the program was to promote the adoption of EHRs. "If we can move the needle on that, then we'll feel like we're successful."

Waldren's main message to FPs is this: "Don't just purchase this EHR because of the Wal-Mart discount. Look at the offer as a package deal with a discount, and if after due diligence it's the right EHR for your practice, then buy it."

The Academy's 2008 EHR member survey indicated that for FPs who have not yet adopted EHR technology, the stumbling block was price. Forty-seven percent of members who didn't have an EHR claimed cost was the reason.

However, Waldren speculated that the Sam's Club discounted pricing could have a ripple effect throughout the health IT market and put pressure on other EHR vendors to lower their prices.

Rollout of the Sam's Club EHR package comes at the same time that the federal government has launched a concerted push to get America's physicians onboard with health IT. Passage of the American Recovery and Reinvestment Act of 2009 gives CMS the authority to reward physicians who implement certified EHRs with anywhere from $44,000 to $64,000 spread over five years beginning in 2011.

However, increased demand for EHR systems could create problems, particularly in terms of follow-up service. Thirty percent of FPs responding to the AAFP EHR survey said they were afraid vendor support would evaporate after an EHR implementation. It's a fair question to ask, said Waldron. Technical support personnel for e-ClinicalWorks will have to be able to handle a big influx of new customers. Will they be equipped to do so?

Heather Caouette, a spokesperson for e-ClinicalWorks, said the company was aware of the potential uptick in demand for service support and was making the necessary adjustments in staff size.

Gjovig noted that the phased-in rollout of the EHR offer would help. "We wanted to first walk before we run; we know the wave is coming of EHR adoption, and we want to make sure that we are prepared to handled that wave," he said.