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Top questions to ask when selecting a new EHR


Vendors don’t offer identical features and services, leaving physicians to determine which one offers the right fit.

Marc D. Price, DO, with Family Medicine of Malta in New York State, is happy with his electronic health record (EHR) software but admits he has complaints.

Among them is being charged for functions he needs to meet insurance and government regulations.

It’s a lesson learned – and something he said he’ll know to ask about next time he selects a new EHR.

Not all EHRs or vendors offer the same features and services, nor does each EHR work well for every practice, so health IT experts said physicians need a good list of screening questions as they make their selection.

HealthIT.gov offers an extensive list of factors to consider when contracting with a new EHR vendor. In addition, several healthcare leaders offered their top questions to ask:

• Is the system 2015 certified? EHRs that are 2015-certified will meet quality reporting requirements are essential for participating in the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM) payment tracks under Medicare reimbursement reform. But Steven E. Waldren, MD, director of the American Academy of Family Physicians’ Center for Health IT, said physicians should also ask “How would I, as a client of yours, be able to fulfill the requirements of and be successful under MIPS?” and “Can you show me how your system will actually work under MIPS?” He said these require vendors to detail how responsive and intuitive their EHRs will be under the new requirements.

• How much customization have other customers needed? Physicians need to know how well a system functions out of the box, or whether a system needs to be customized to each physician practice before it works well, Waldren said.

• Will you agree to payments based on milestones? Software contracts often require payments on specific timelines, said Derek Kosiorek, CPEHR, CPHIT, principal consultant at the Medical Group Management Association Healthcare Consulting Group. He advocates for payments based on milestones of implementation instead. Key implementation points are the contract start, successful training of employees, successful testing and successful go-live. This payment structure creates better incentive to get the job done.

• What’s your response time? Seek out great customer service that’s also delivered quickly. “My EHR gets back to me within five to 10 minutes. You want to have that responsiveness. I’ve heard about others where it takes days to respond,” Price said, adding that it’s wise to ask whether they charge fees for support calls, too. It’s also smart to ask about the vendor’s customer service hours, Kosiorek said.

Next: Three more questions that need to be asked


• What’s your company’s future? Kosiorek said mergers and acquisitions among EHR vendors can leave physicians without support, so ask potential vendors how they can guarantee that the company and its products will exist in five years.

• Can I see the EHR in use? Price has had colleagues visit his office to view how his EHR works in day-to-day practice. Such visits provide a more complete picture than a discussion with a sales rep or even a phone call with another physician, he said, as visiting physicians can see, for instance, how many clicks it takes to enter data and how well it integrates into specific workflow practices.

• What happens to the data when I change EHRs again? This has become a sticking point for many physicians as they switch vendors, with some vendors charging large fees to transfer records into new systems and others facing problems making the data accessible in new systems. So ask vendors how they’ll handle the process, Waldren said, and consider having vendors use a third-party provider to escrow the data through the life of the EHR contract. That helps ensure that the data will remain available to the physician when he or she parts ways with the vendor.

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