Strategies for picking the best EHR system for your practice

This information is part of a Medical Economics exclusive ranking of the top 100 EHR companies. (medicaleconomics.com/top-100-EHRs)

Gail Levy, M.A.

Given the diverse options with EHR use, significant variations in practice operations and the complexity with achieving a fully integrated paperless work environment, it is critically important for physicians to establish a strategy prior to initiating a review of EHR systems.

Not only will this save time and avoid spending money where not needed, it will also minimize unwanted surprises.

Consider the following as a first step when identifying practice requirements: patient health information

Kathryn Moghadas RN, CLRM, CHBC, CHCC, CPCdocumentation at both the time of service and pre/post treatment, viewing and reporting information stored in the EHR and provider and staff utilization of the system.

Use the following tips when developing your strategy and as you evaluate the systems.

Vet the vendor

Here is what you need to find out about the EHR vendors you are considering working with:

• Check vendor’s referrals and references.

• What is the vendor’s experience? How many installs and client types? How many providers and sites per business entity? 

• Does the vendor have certified products for 2011 and 2014?

Vet the system

You also need to do your homework on the specific EHR systems you are considering.

Use the following tips when researching EHR systems:

• Identify the number of installs (business entities) and physicians and NPPs that had adopted use of the system.

• Break out the numbers by specialty and ownership type (private owned, hospital/ids owned).

• Is this an integrated EHR with a Practice Management (PM)component? or is the PM interfaced with EHR (were these two separate products that have been “married”)?

• If considering just an EHR product, get the details on what PM products interface with the EHR and what is required (cost and process wise) to implement and maintain bi-directional integration.

• Number of years EHR system has been in in active use

• Ownership history

• Any mergers?

• Does the company own other products and if so what are they?

• To what extent is the EHR product the owner’s primary source of business?

See the EHR in action

Observe with as much detail as possible other practices (at least three practices, if possible) using the system.

It’s important to see how the system works in the real world before purchasing it.

What about cost?

It is very difficult to predict realistic comparative cost expectations associated with the acquisition an EHR. 

Factoring the software alone will not provide a realistic estimate.  Practices with no existing hardware will incur the highest cost.  Practices using IT equipment more than three years old and near maximum capacity are likely to spend as much as a practice with no hardware. 

In general, if just an EHR is purchased, the practice may have the lowest implementation cost;  However, if these practices pay for a Practice Management (PM) system integration with the EHR the total costs are likely to be close to fully integrated EHR/PM systems, though this scenario will avoid the transition to a new PM system. 

You purchased an EHR system. Now what?

Once you’ve selected an EHR system, the work is far from over.

Here are some tips to make sure you get the most from your systems:

1. Use the patient portal

Initiate use of patient portal as soon as possible.  Document management and patient communications are two areas where practices can significantly improve operations and gain efficiency.  The patient portal is almost always placed as the last step in the implementation and use plan.

2. Interoperability is key

Interoperability provides significant value with EHR use.  Don’t short change your investment by trying to save costs by delaying opportunities to interface with other systems that are able to provide receive and/or provide patient data.

3. Usability 

When selecting a system consider the impact and usability for the provider, staff and patient.  While the provider may be very significant, failure to assess impact for staff and patient may become a provider problem.

4. Pay attention to ‘ease of use’

Concentrate on ease of use once the system is fully operational and providers and staff are comfortable with EHR use rather than focusing on the ease of implementation and training.  EHR use will have a far greater impact on practice cost and working environment over time than during the initial implementation period.

5. Gather concise, focused analysis

During the system set-up/configuration phase allow provider(s) and staff time for concise, focused analysis and planning that ensures the essential basics are thought through, thoroughly.  Avoid trying to tackle every detail as this may create more limitations and/or complexities than helpful.

6. Use the vendor’s knowledge

Ask the vendor to show you what set-up options/configurations have been developed that are the most likely to enhance system use.  That will make your job easier.

7. Change your practice, not the EHR system

Consider the implications of making practice changes rather than modifying the EHR system as in doing so, the practice may realize operational improvements, which they otherwise would not have considered.

8. Assess your needs regularly

Assess annually the need to adjust the software contract and user licenses to accommodate the changing needs of the practice with the number of employees, portability of employees or providers who might need remote access into the EHR system. 

9. Will you save money?

The reason for implementation of EHR is for compliance with emerging standards of patient care documentation and delivery. Negate all claims that you will either save time or money.

10. There will be a learning curve

As with any new equipment or procedures incorporated in your practice, there is a learning curve that all employees must accept. The employee with technology skill sets will adapt quicker than the employee who has to become familiar with basic computer skills. Assessing the employee’s readiness and providing initial training to those who need basic skills through local adult education classes will assist the practice in the adaptability to the new processes. 

Gail Levy, M.A., of The Levy Advantage, Baltimore, Maryland, and Kathryn Moghadas RN, CLRM, CHBC, CHCC, CPC, of Associated Healthcare, Orlando, Florida. Send your practice management questions to medec@advanstar.com.