Choosing the Right EHR

These strategies will ensure success for you and your organization

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With the increasing importance of electronic health record (EHR) systems and their role in improving providers' administrative operations and streamlining the delivery of patient services, it has become evident that far too many providers are dissatisfied with their EHR vendors. In a recent report, KLAS found 50 percent of 300 physician groups that have purchased EHR systems are now looking for replacement systems - up from 30 percent in 2011.

Provider Dissatisfaction
As an EHR system provider, there are two main reasons for this wave of provider dissatisfaction from our perspective.

First, many physicians are basing their decision primarily on cost factors, not realizing that cheaper is not necessarily better. Second, many practices are not 100 percent comfortable with their own internal processes, and as a result, purchase an EHR system that does not satisfy their needs.

Evaluating Needs
When considering if an EHR solution is right for your organization, take time to evaluate the current needs and future goals of the practice, and then look at what you can realistically afford to invest in a system. It's important to weigh out whether or not a perceived expensive initial cost will save you money in the long-run.

Next, analyze your workflow to see which processes you would like to maintain and what areas you would like to improve. This will help in cultivating efficiency and organization throughout the practice, while ensuring that your EHR system supports your goals.

Then, it's time to begin looking for systems and vendors to meet the specific requirements of your practice. It's important to understand that there is no one-size-fits-all solution, even within the same medical specialty. For example, two dermatology practices might have different workflows and business systems. Once you have narrowed the list of vendors, be sure to check references and try to speak with several clients in your specialty that have been using the system for at least a year. They can tell you about any obstacles encountered during the implementation, their support experience and the benefits from making the switch.

Steps to Selecting the Right EHR System
Here are some other suggestions to purchase the right EHR system for your practice and avoid a costly mistake:

• Be certain you understand the total cost of ownership (TCO) of each vendor's pricing structure. For example, some cloud-based vendors provide EHR services on a subscription basis. Paying $400-$600 a month for a five-year contract period would result in a $30,000 commitment plus the initial investment for implementation and training. Alternatively, the TCO for a server-based office system with a $10,000 upfront cost and a $200 monthly maintenance would only be $22,000.

• Look for hidden costs in the contract, such as additional fees for in-person training, document management services, EDI setup, or annual maintenance fees in addition to the monthly support costs. Also, watch for provisions that allow the vendor to increase fees during the course of the contract.

• Ask the vendor if the system will accommodate any potential changes in your practice model. This could include, for example, joining an accountable care organization (ACO), adding telemedicine services, or expanding upon the practice concentration in the future (i.e. bariatric, weight management, etc.).

• Consider the EHR system from the point of view of the patient, as well as the physician and office staff. For example, is the EHR system easy to use in the examination room? Does it provide reports on waiting times or other service delivery issues?

• Look for hidden costs in the contract, such as additional fees for in-person training, document management services, EDI setup, or annual maintenance fees in addition to the monthly support costs. Watch for provisions that allow the vendor to increase fees during the course of the contract.

• Be sure that you "own" the data under the terms of the contract. Some vendors charge a fee for exporting the data to a new system before the contract expiration date.

• See if there are provisions that would allow you to get out of a contract after six months or a year. This is essential if the system ends up not working for you.

• Finally, be sure you are comfortable with the vendor. In many cases, a smaller or mid-size company can provide a higher level of personal service. That's an important consideration in helping physicians and office staff take advantage of the many potential benefits of deploying an EHR system customized to the needs of the practice.

Kirk Treasure, VP, Sales and Marketing, Meditab Software.

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