Finding the Best EHR for Your Medical Practice: 10 Key Questions to Ask EHR Vendors

Selecting an EHR system for your practice can be difficult and time-consuming—every vendor claims to have the best EHR system on the market, and every EHR has a multitude of features and specific functions that may or may not complement your practice workflow. So, how do you choose the best EHR for your medical practice?

We’ve compiled the top 10 questions to ask EHR vendors:

1. How many practices in my specialty are currently using your EHR system? Can you provide a list of references?
The EHR vendor should provide a list of practices in your specialty with a similar size that are using their EHR system. Request 10 references and split the calls among your employees. Provide a list of questions so that each call covers the same material for easy comparison.

2. What benefits will my practice experience with your EHR? Does the EHR software fit my workflow needs?
Beware of getting sidetracked by bells and whistles. Make sure the EHR system is specialty-specific and has the functionality your practice requires to support your current workflow.

3. Can I test drive the EHR software?
Have the EHR vendor give you complete control during the demonstration so you can see how easy the system is to use. Measure the time and number of clicks it takes to go through a typical patient encounter, then an atypical encounter, and then compare these to the time it currently takes you to see a patient without using an EHR. If it isn’t more time-efficient, the system is not for your practice.

4. Does the EHR integrate with the current software system(s) in my office?
Ask how easily the EHR will integrate with your current software systems (if applicable) and how much that integration will cost. In addition, ask who will provide support if there are any problems with the integration.

5. Where does the patient data reside—who owns it?
Find out if the patient data will reside on a server in your office or at the EHR vendor’s facility. Ask if you will have full access to the database to retrieve patient information and if you will be able to write a custom interface without EHR vendor interference. In addition, ask what format your data will be in if you decide to stop using that EHR vendor in the future and if you’ll be able to retrieve/transfer your patient information.

6. Will the EHR software store data in a client server or does it use ASP/SaaS technology?
For a client server, request hardware specifications and pricing. Ask how often you will need to upgrade, how reliable the server is, and about backup services. For ASP/SaaS technology, ask what high-speed Internet connectivity requirements will be needed for smooth/quick access. Furthermore, ask the vendor if there is a backup plan if the Internet goes down—inquire about the location of the data and if you will have access to it.

7. What is the average time between purchasing the EHR and going live?
If you are trying to qualify for the EHR incentives, ask how long implementation takes for a practice in your specialty and size. In addition, ask the EHR vendor if there is a long waiting period before implementation can begin. Many EHR vendors are backlogged and have a waiting period of 3-4 months before implementation can begin.

8. Who will implement the EHR system and train my staff and physicians?
Question the experience of their implementation team. Ask if a senior implementation specialist will lead the team and if s/he has successfully implemented the EHR in multiple practices in your specialty and size.

9. How responsive is customer support?
Support plays a crucial role—this department can make your job easier, or it can lead to more stress, especially if the EHR vendor is unresponsive. Ask what the support hours are, what the turn-around time is from when a problem is reported to when you receive a response, and ask the EHR vendor’s references to rate their customer support.

10. Is there a warranty? What if the EHR system fails?
When asked, some EHR vendors will provide an EHR warranty. Make sure the terms and conditions of the warranty are covered in the contract(s). Warranties can be useful and provide peace of mind, especially when making an investment of this magnitude.

Selecting the best EHR for you medical practice can be challenging, but the questions above can help you evaluate EHR vendors against your specific workflow needs. Compare the answers and call your top choices for references. Join us next time for a list of the most important questions you should ask EHR vendor references.

EMR and EHR: Where Are You Getting Your Information?

Given the complexities of medical practice today, many physicians and administrators are forced to look to external resources for information and education:

  • Consultants
  • Other practices and colleagues
  • Professional societies and the member meetings

With the breadth of topics to cover, however, these sources don’t have the resources to become experts on every subject. Ask physicians about treating patients and they’ll answer in a heartbeat—ask them about meaningful use and they may be at a loss. Ask your billing consultants about the best way to code an exam and you’ll hear an efficient plan. Ask them to explain how all your equipment and external sources will integrate with an EHR and how it will impact physician workflow, and they may have to defer to the IT and workflow specialists.

So who should you trust as your EHR source?
Look to credible EHR sources that have relationships with professionals in your specialty. Colleagues who have completed a comprehensive due diligence process and are continuing to search out the most updated information available can also be valuable resources. You can also seek consultants who are dedicated to the specific area for which their expertise and guidance is being sought.

Where do you look to find these EHR sources?
There’s a multitude of resources out there in the market. On a peer level, many physicians and administrators are active on medical listservs such as MGMA and AAOE where you will hear real-life EHR stories and experiences that you’ll want to consider. LinkedIn also has active discussion groups that offer a forum to ask questions and learn from others.

In addition, many websites and blogs have been created to share and interpret relevant EHR information from government resources. Just keep in mind that the information presented should come from a trusted source without much interpretation.

At SRS, we are dedicated to educating our clients and prospective clients. Our Government Affairs Team is immersed daily in the details of the government’s healthcare-related programs and continually advocates on behalf of physicians and medical practices. As a result, we are constantly up to date with the latest government affairs and have made all the pertinent information available in our Gov’t Affairs learning section of our website. The section includes information about:

Understanding the increasing volume of information pertaining to the EHR industry is a considerable challenge to undertake. It is only wise to invest your time in credible EHR resources. The information provided on government websites can certainly be a task to break down. Find an EHR resource that clearly and concisely interprets the wide variety of information that is available. And again, be sure the EHR resources in which you confide are trusted.

Don’t Sit on the EHR Fence Too Long

When it comes time for medical practices to select an EHR, many physicians and administrators prefer to sit on the fence. They are waiting to see about the success or failure of their colleagues, and in many instances, they are waiting to see if the meaningful use incentive payments will actually be made.

Don't Sit on the EHR Fence Too LongWhile learning from the experience of others is always a smart technique, purchasers must be wary about waiting too long—especially if they have the government’s EHR incentives in mind.

Although physicians can receive the full EHR incentive payments if they begin reporting in 2012, there are many milestones that need to be passed first. Searching for the right EHR for your practice, implementing that EHR in your practice, and making sure your employees can successfully use the EHR system to demonstrate meaningful use—all need to be successfully accomplished before the start of your 90-day reporting period.

So how much time do you really have?
Not much at all—the last day to start demonstrating meaningful use and receive the full incentive payment is October 1, 2012. That means practices should look now and select an EHR solution no later than this fall.

Why the rush?
For a dedicated practice actively searching for an EHR, the average time it takes to research EHR vendors, receive information, schedule demonstrations, talk to references/colleagues, perform comprehensive due diligence, negotiate terms/conditions, and gain approval from practice leaders can take anywhere from 4 to 9 months in a rushed cycle.

Once an EHR vendor has been selected, implementation can be scheduled. However, there are numerous steps, timelines, and milestones that must be met here, too, before a practice can go live on the EHR system. The exact duration of implementation is dependent upon multiple factors, some of which include:

  • Vendor backlog
  • Amount of information to be digitized
  • Size of facility
  • Specialty (services offered at the facility)
  • Training/learning curve
  • Hardware/software

Only an EHR vendor with an experienced and professional staff dedicated to providing unparalleled customer service can seamlessly and successfully guide you through these crucial steps in time for October 1, 2012. The crush of orders that vendors are receiving due to the tight meaningful use timelines has created a vendor backlog and makes a fast implementation impossible. Many vendors boast a quick implementation timeline, but cannot deliver on their promise without disturbing practice efficiency, patient volume, and overall practice morale.

Don’t sit on the EHR fence too long. Invest your time wisely and research EHR vendors that have a proven track record of superior customer service and support. Keep in mind practical EHR implementation timelines when you are purchasing an EHR that best suit the needs of your physicians and medical staff. Rushing into an EHR implementation can have devastating consequences on your practice’s bottom line. Educate yourself and your practice about the requirements necessary to meet the meaningful use criteria set forth by the government.

To qualify for the full meaningful use incentives, waiting is no longer an option—it’s time to get serious about purchasing an EHR.

EHR: Experience from the Field

At the recent HIT Policy Committee public hearing in Washington D.C., many speakers with experience in the field commented about electronic health record (EHR) vendors, implementation, and functionality. For those of you currently engaged in an EHR search process, plan to begin one soon, or are considering switching systems, the comments below from the public hearing should be considered:

  • EHR: Experience from the FieldThe impact on productivity was described by one physician as “death by a thousand clicks.”
  • The impact of EHR on patient care was that clicking through screens, inputting data, and checking boxes took time away from the patient.
  • “Vendor solutions are often awkward and time-consuming.” They may accomplish the meaningful use task, but they are not very usable themselves.
  • “EHR implementations fail when they become IT projects instead of clinical projects involving technology.” The selection of an EHR should be workflow-based; the vendor must have a common-sense approach to workflow.
  • EHR vendors are scrambling to keep up with the changing government demands for reporting functionality. This frequently results in misrepresentation of the software’s current abilities.
  • There is deep concern that practices are rushing to install EHR systems to meet meaningful use, only to find out that the EHR doesn’t meet the needs of the practitioners—this will be very costly in the end.

These EHR experiences are from the frontline trenches of EHR adoptions and implementations. They rightfully instill a “look before you leap” mentality for physicians and medical practices undergoing an EHR implementation, EHR replacement, or planning an EHR selection process.

Don’t fall victim to an EHR implementation that will hinder your productivity and have a negative impact on patient care. Consider these 3 tips during your journey into the EHR field:

  1. Identify EHR systems that are usable and focus on your specialty’s workflow needs.
  2. The EHR vendors you are considering should have a proven understanding of your practice’s daily clinical operations and must meet the needs of your physicians.
  3. Be sure that the prospective EHR vendor solutions also have many viable references in your specialty, practice size, and patient volume.

By taking the necessary steps and performing the appropriate due diligence, your EHR selection process and EHR implementation will go smoothly…and your “experience from the field” will be much better than some of those who spoke at the HIT Policy Committee public hearing.

EHR: Where’s the References?

The conference hall was filled with EHR vendors at the recent American Academy of Orthopaedic Executives (AAOE) conference, and yet there were scarcely any client references to be found. With only one exception, no vendors displayed the orthopaedic practice logos that represented satisfied and happy customers.

EHR: Where's the References?Why would this be the case? This is the venue for vendors to share their successful implementation stories with potential customers, and there was an eager audience shopping for EHR systems in attendance. Why is it that client logos were virtually nonexistent? Where were the references?

The AAOE conference offered orthopaedic practice administrators and physicians the opportunity to view a broad selection of EHR products. Vendors had the chance to show off their solutions, highlight their bells and whistles, and declare that the product they had to offer was the best for the attending audience.

Of course, it goes without saying that all vendors will claim their EHR is the best. So how do administrators, physicians, and IT specialists distinguish among the choices? Do they trust the claims of the vendors themselves and rely on the slick demos and information they provide? Or is it more beneficial to hear what customers have to say about the product and service provided by each vendor?

We advise practices involved in the EHR search process to require each vendor they are considering to provide a large sample (at least 10) of references in the same specialty and of similar size.

SRSsoft at AAOEIf a vendor cannot provide this to a potential customer it should be a red flag. SRS proudly displays the logos of the multitude of happy clients at every conference we attend. In fact, our conference booth is designed to showcase our satisfied customers—it’s what made us the only exception at the AAOE conference.



From the Field
by Ben Reynolds, SRS Midwest Region Sales Manager

As you can imagine, it has been a very busy time for us in the sales department of SRS. Between the ever-evolving details of meaningful use and the looming ePrescribing deadline, there hasn’t been much time spent in the office.

Interestingly, many of the prospective clients I’ve been meeting are not what you might expect. It hasn’t been the practices making their initial foray into the electronic world from paper charts that have been keeping me busy. Rather, it’s been the practices that have already attempted to implement an electronic health record (EHR) system, struggled mightily along the way, and ultimately failed to implement the system to its fullest potential.

Why is this? Based on what I see every week in the field, these struggles occur when a high-volume specialty practice attempts to implement an EHR system that was developed for an internal-medicine, primary-care clinical workflow. These EHRs are built around knowledge-based templates as the exclusive route to documentation. That may be an acceptable pathway for a physician documenting a standard SOAP note, but for the busy specialist, that path is equivalent to the switchback trails leading up Mt. Everest—an impossible and impassible trek fraught with peril and requiring many “Sherpa” (usually in the form of scribes) to make the ascent.

Now these practices are looking to SRS to solve the problems created by the failed attempts to shoehorn these narrowcast EHR systems into their practices. Why the SRS EHR? Because we have created our FlexNote™ documentation suite around a productivity-based workflow. Other companies have forgotten that the note can’t occur if it isn’t created and managed in the context of a productive workflow. We know that the physician’s encounter and documentation is best facilitated by a fully automated office—it’s what we do best. It’s why we have over 5,000 happy and successful providers in our EHR national network. It’s why we confidently post the logos of these clients on our marketing literature, our website, and our conference booths.

So, if you are thinking about replacing your current EHR system, or moving away from the burdensome world of paper charts, ask yourself: “Is my challenge only physician documentation, or is it everything that surrounds that, along with creating a more efficient and productive medical practice that provides an enhanced level of patient care?” If it’s the latter (and it should be), contact us.