The Circumstances and Challenges
The organization was struggling. It was providing a range of behavioral health services, from outpatient visits to the Intensive Outpatient Program and Partial Hospital Program to residential care facilities. The organization had installed an electronic health record system about two years previously, but the system did not support all of the treatment options offered (e.g., residential care), and not all therapists were utilizing the system, even for recording outpatient visit notes.
The Change and Selection of a Consulting Firm
Organization leadership was considering EHR replacement, even though initial licensing and training costs of the existing EHR system had already been paid. A decision was made to retain The Fox Group, LLC to evaluate options for selecting and implementing a new EHR system.
As part of assessing the perceived need for a replacement EHR application, The Fox Group interviewed leadership personnel as well as staff members about the use and usefulness of the current EHR. Deficiencies cited included lack of reporting capabilities for patient activity, patient census demographics and billing activity/accounts receivable management. Other aspects of system use such as training new users were not emphasized as much as required due to staff turnover in key positions related to the application.
The Solution, Outcome, and Sustainability
The Fox Group structured a process to select and evaluate alternatives to the existing EHR application but decided to include the current system in the evaluation. The Fox Group identified EHR vendors who supported behavioral health practices and sent a customized RFP questionnaire to 9 different vendors. The RFP asked about issues such as application capabilities across a spectrum of functions, customer support, implementation and documentation, and training.
Product demonstrations by five vendors were then scheduled for the consultants and representatives of the organization. A checklist was utilized for demonstrations to ensure each vendor addressed the same range of application functionality. Finally, the references for each vendor were contacted to provide information on how the vendor was perceived by a sample of its customers.
A final Vendor Comparison matrix was prepared, comparing the results of the responses to the RFP questionnaire and the demonstrations, and listing the advantages, disadvantages, and costs of each vendor, so that an ROI could be calculated as well.
In the end, the organization realized that the solution was the EHR system it already had installed! It only needed to re-dedicate itself to utilizing all of the capabilities of the application and work with the current vendor on improvements in reporting and forms generation, while the vendor worked on expanding the application for use in residential treatment settings.
And of course, this was far and away the most cost-effective option, saving the organization an initial investment of over $130,000, plus hardware and staff time for training on a new system.