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mepal, you say that the facility should pay to implement EMR. The costs of implementing EMR–equipment, training, staff, etc–run into the millions. Efficiency of doctors/ support staff will obviously decrease during the training/ learning/ software customization period, and patient care will suffer. Nearly every hospital will need to cut something out of their budget to pay for this. Most hospitals will choose to cut their least profitable or money-losing departments. This may include eliminating ER beds, cutting nursing staff, or laying off entire departments (one hospital near here eliminated all pediatric subspecialties, from cardiac to orthopedic).