After 2 1/2 years only 2/3rd of the physicians have adopted the system. Maintenance does not seem to be sustainable and they are still deciding on whether to keep control of the servers in-house or have them housed off-site. In short, her practice is hitting a road block that completely derail using EMR for anything more than billing, booking and lab work.
The story underscores an important point. The cost of maintenance, replacement and network design. When our office created the network, we gave little thought to the cost of network architecture and maintenance. The reality is that it (and bandwidth) can make a sizable portion of the total IT budget. The typical cost of an 'entire' system (back bone, servers, bandwidth and workstations) can easily reach $10,000-15,000 per work station for set-up. Clinicians often focus on the utility and cost of EMR without seeing the 'hidden' costs.
We are now 5 years into implementation and still not paperless. But, our system is stable, sustainable and has a calculable return on investment (of about 1 year).