By the time you submit an RFP—the document that helps you determine if an EHR has what you need to meet your EHR and practice goals—you’re serious about purchasing an EHR. RFPs are well intended—they are used to weed out inappropriate EHR contenders and to focus on asking the questions that are important for your practice.
Unfortunately, most RFPs do not address all the crucial topics and questions. In fact, many RFPs focus on the bells and whistles and other superficial components of an EHR, but don’t address the most important factors that actually make or break a successful EHR adoption.
Wouldn’t it be nice to address those factors?
RFP—the request for proposal—it’s an interesting choice of words. It’s nice to learn what vendors “propose,” but wouldn’t it be better to know what they will deliver? With the right questions, a generic RFP can transform into an RFD—Request for Deliverables.
So, what’s missing to make your RFP an RFD?
Here are 5 critical categories—and related questions—that should be included in an RFD. If these are given priority, you have a much greater chance of making the right EHR decision the first time around.
A structured implementation timeline will help to set realistic expectations for your practice. An experienced and professional implementation team will make success more probable. Identifying additional training costs and securing reimbursement in the event of an implementation failure will save you from an unpleasant financial surprise to your bottom line.
2) Company size and bandwidth
The bandwidth of the EHR company is extremely important. The EHR company should have a development department large enough to keep up with the rapidly changing government regulations that define how an EHR should work and how data should be shared. EHR companies with development teams that are too small will most likely not be able to keep up with these changes.
3) Efficiency and productivity
The amount of time and clicks it takes to move through a standard patient encounter is critical in a medical practice—conducting time/click comparisons among EHR vendors is a good way to measure EHR efficiency. It’s important that these efficiency comparisons be done by members of the medical practice and not demonstrated by a tech-savvy sales expert. Additional clicks and windows add a cognitive burden to physicians and hinder the seamless flow through patient encounters. Anything that distracts the physician’s focus from the patients benefits neither the practice nor the patients.
4) Support and customer service
Superior customer service and timely support should be the cornerstone of all EHR companies—support turnaround time is crucial to the workflow of your practice. Your RFD (RFP) should also include a box to put the EHR vendor’s KLAS rating.
Collecting EHR reference feedback is one of the most critical steps in the EHR search process. Providing 10-20 references will highlight the vendor’s experience in EHR implementations in practices similar to yours. Make sure your physicians call other physicians at random from each reference site.
Make RFPs more valuable to your EHR search process.
Include usability and performance questions that are not seen on typical RFPs. A well-crafted RFP (now RFD since you are measuring deliverables like usability and performance) will identify how the EHR performs, how the vendor handles client relations, and will give you true insight into whether the EHR will actually deliver on its proposal to your practice.
So, is it time to break up with your EHR vendor?
We’ve talked about the good, the bad, and the ugly EHR stories we’ve heard over the years. If your experience falls into the “bad” or the “ugly” categories, you may want to consider breaking up with your EHR vendor.
Here are the top 6 reasons medical practices’ relationships with their vendors end up on the rocks:
If any of the above sounds familiar, it may be time for you to break up with your EHR vendor and make lemonade out of your EHR lemon.
So, how do you break up with your EHR vendor?
Parting ways with your EHR vendor doesn’t have to be a difficult, stressful ordeal. Here are the 4 items you’ll need to review to make the process easier:
Nobody wants to be stuck in a bad relationship—the same goes for relationships with EHR vendors. With so many EHR systems available on the market, finding one that suits your clinical workflow and productivity needs is a much better option than sticking with the inefficient EHR system you may currently have.
Don’t settle for less, find the right EHR match for your practice.
In 14 years of business, we’ve heard thousands of EHR stories from physicians, administrators, and other medical staff. We’ve noticed a few clear trends as the stories fall into 3 distinct categories. Let’s call them the Good, the Bad, and the Ugly:
“With [ABC] EHR, I navigate my patients’ clinical data faster and more efficiently, and I don’t have to wade through other physicians’ notes to get to my own notes. It’s quicker to electronically prescribe than to write out a paper prescription, and it bypasses the sloppy handwriting problem that can lead to errors. This results in better patient care and can lead to sharply reduced malpractice risk. In addition, our response time to patient inquiries has improved greatly, which is something our patients have gladly noted.”
“One of the best things I love about our EHR is that I can check the charts from home. Sometimes patients make appointments before they are instructed to, which doesn’t allow me to maximize my time in the office. I also spend less time in the office doing research and can easily accomplish my research goals from the comfort of my home.”
“Because of the efficiency gains [QRS] EHR brings to our practice, the staff now spends more time reviewing patient charts for quality and completeness, which has directly enhanced the level of patient care. Patient satisfaction levels have notably increased, as has the physicians’ confidence in the comprehensiveness and quality of the clinical data.”
“Our EHR is the primary tool at the foundation of our practice—the tool that the physicians and staff count on to be reliable, provide accurate clinical data, and build and secure the integrations necessary for the current and future digital age.”
Trend: The good EHRs deliver substantial practice workflow enhancement and productivity improvement, while simultaneously creating an organized and less stressful work environment for the physicians and staff. The good EHRs support an enhanced level of patient care and help create an improved patient experience.
The Fix: If you fall into this category, consider yourself a success story—sit back and marvel at your practice’s new-found efficiency and focus your attention on the patients and growing your practice now that inefficiency and stress are no longer a part of your day.
“[XYZ] EHR is quite complicated, and we ended up having to hire a full time, in-house IT employee. We rolled out the EHR to physicians from April to June. The doctors who went live in April and are really good with the system are still 25% down in productivity. This has slowly been improving, but the doctors have quite a lot—about 2 hours—of ‘after work’ to catch up at the end of the day. We had to set up VPN connections between the office and every doctor’s home so they could finish their work at home.”
“It took our practice four years to narrow down and select an EHR vendor. We went live 6 weeks ago and our physicians say they are doing more work now than they were before. One of our physicians says he has to cut patients out of his schedule on a daily basis. In addition, he used to go to the hospital at 6:45 AM and get home at 6:15 PM. After implementing the EHR, now he leaves the office at 7:00 PM and his wife and kids are upset with him for the lost time. He is also upset that he has to do more work, manually entering in patient data, which is not why he became a doctor. He became a doctor to take care of patients, not to type and treat fewer patients. The only good thing he could see from it is being able to access patient charts from home, and then perhaps a light at the end of the tunnel for better patient care sometime in the future (keyword = sometime). The check-out staff member said, ‘They trained us in two days and then left us for the wolves.’ It was real bad, patients were very upset.”
Trend: The bad EHR stories always involve practice-wide workflow disruption, unexpected increases in expenses, decreased quality of life, and/or decreased patient satisfaction.
The Fix: Call your EHR vendor and request their Professional Services Group to come in and evaluate your practice’s workflow. Whether your staff needs more training or more face-time with super-users, your EHR vendor should take care of you. (After all, they want you to succeed using their EHR, right?)
“We are a 200+ physician group that signed with an EHR vendor 3 years ago. Satellite offices that have already gone live on the EHR system are still using paper charts and writing prescriptions by hand. Our central office planned to fully implement this fall, but we have suspended that indefinitely since the other offices that are already live on the EHR had patients lined up out the door due to slowness and difficulties using the EHR.”
“After trying to use the EMR and failing, we SHUT IT OFF! We have 7 doctors—our head doctor made numerous calls to the higher-ups at the EHR vendor to try to get the program to work. Nothing worked and he’s 100% convinced that they just don’t understand our specialty.”
Trend: The ugly EHR stories always involve failed EHR implementations, extreme productivity losses, physician and staff frustration, and wasted revenue.
The Fix: Go over your contract to see if you have a “failed implementation” clause. Many EHR vendors guarantee success or are willing to work with your practice towards EHR implementation success. However, in some cases, the EHR vendor can’t fix the problem because the software just doesn’t match your practice workflow or their support/implementation teams are inexperienced. Sadly, if this is the case, it might be time for you to break up with your EHR vendor.
But all is not lost, many EHR vendors offer transfer pricing from one software to another. You’ve learned from past mistakes and the next time you’ll know what your practice requires to achieve success and the questions to ask to make sure the vendor will deliver it.
Don’t feel stuck—you too can have a happy ending:
“After suffering through three failed attempts to implement traditional EMRs, we were thrilled to find a solution that was fully embraced throughout our entire enterprise. This EHR vendor clearly understands our complex clinical workflows, and their robust EHR easily conformed to the diverse requirements of each of our providers. We could not have found a better partner.”
“My job is taking care of patients.” We agree.
With the full-time job of taking care of your patients and staff, who has time to worry about an EHR system? You’re already bogged down with too much bureaucracy, worried about whether your patients will follow your instructions, and concerned if you’ll see your next patient on time.
But did you know an EHR system can actually help you provide the exceptional patient care you want and free up your time? The right EHR can minimize paperwork, create a calm, proactive medical staff, and keep you on schedule so you can leave the office on time.
So doctor, what’s in it for you when it comes to an EHR?
1) Accomplish your goals. Spend less time with busy work and more time doing what you love, whether it is research, seeing more patients, going home earlier, or getting to an afternoon tee time. An EHR focused on your workflow will enhance the time you spend with your patients and the care you provide. Say goodbye to waiting and inefficiency and hello to a smoother day in the office and a better lifestyle.
2) Control your bottom line. If you’re like the physicians we know, you watch your schedule like a hawk. Patients that make appointments before they are instructed to or who do not have their test results back in time can be rescheduled to make room for new patients in your schedule. With the right EHR, it only takes minutes for your staff to proactively review and prep your next day’s charts, making sure you are spending your valuable time productively and maximizing your time in the office (and your bottom line).
3) Share clinical data instantly. Patient information entered in the digital chart can be shared simultaneously with your staff and referring physicians. Transferring a patient call from the front desk to the physician? No problem—you have immediate access to the patient’s clinical data including the most current notes entered by any member of your staff, so you can answer the inquiry quickly and easily.
4) Provide quality care. An EHR allows you to access your charts from anywhere at any time. Preoccupied with answering on-call inquiries at night without reviewing patient information? Respond to patients confidently with their clinical history, last exam note, and any test results right at your fingertips. Not sure if your patients are following through and taking the tests that you ordered? Track orders and results and feel confident that your instructions are being followed.
5) Enhanced Communication. Communicate with your scheduler, nurses, and entire staff in a quick and efficient manner. All this can be accomplished from wherever you may be—home, office, or hospital.
Of course, not all EHRs are built the same. Finding the best EHR for your medical practice is key to a productive office and a better quality of life.
In your search for the best EHR for your practice, you’ve already asked the 10 Key Questions to Ask EHR Vendors; now it’s time to see if their responses live up to your expectations. However, you can’t rely entirely on vendor promises—the only way to get a clear and truthful picture of whether an EHR vendor can deliver what it promises is by speaking with its current and past clients.
Collecting EHR reference feedback is one of the most critical steps in the EHR search process, and it is most easily and effectively managed when split among practice employees. If each employee makes a few calls, the interview process will not require a large time commitment from any one of them. Further, both administrative staff and physicians should call so they speak to their peers at the reference sites, and your practice should speak with several physicians and staff members at each facility to collect different perspectives and opinions. Finally, don’t just call the references provided by the vendors—find other practices using the EHRs you are considering by joining listservs such as MGMA, AAOE, and other professional societies.
After you have 10 references from each EHR vendor of practices with a similar size and specialty—along with a few practices that weren’t provided by the vendors—ask each reference these 12 crucial questions:
Asking these questions will give you a clear indication of whether or not a specific vendor will be able to deliver the success you expect from your EHR implementation.
Keep this “cheat sheet” of reference questions handy throughout your EHR search process. It will prove invaluable and provide you with the information you need to save yourself from a potential mistake.