EHR Installation – Surprise Extra Costs

EHR Options & Extra Cost Items

EHR vendors will almost always have options and extra costs associated with their system from a performance or enhancement position.

Some examples include

  • patient portals,
  • mobile devices,
  • report suites and updates of third party data bases such as formularies.

Legitimate vendors will be forth coming and volunteer information. But there are some vendors who have the belief and conviction that individual physician practices – and especially groups –  have ample and abundant resources to pay for extras that they may or may not need.

I strongly advise that you be prepared to ask vendors to verify the existence, benefit and cost of these items during the initial stages of the evaluation process. It is vital that you estimate these items and considers the total costs – and benefits, to get a more accurate and realistic appraisal of the financial commitment that will be required to make an organization operational and in full compliance with the specifications and regulations set forth by the Government.

It will be up to the provider, not the vendor, to meet the full expectation of “Meaningful Use” and to realize the maximum incentive reimbursement allowable under the HITECH Act.

Options and extra costs can be divided into three groups:

  • System Options
  • Extra Cost Items
  • Software, Hardware, Network and Office Infrastructure Costs

System options can be patient portals, electronic prescribing of drugs, electronic faxing, access to a database of drugs and their description and reactions, scanning of documents and secure e-mail capability to mention a few. These items can be relatively costly. However the most expensive options are interfaces that are needed to communicate with hospitals, laboratories, imaging and radiology organizations.  Many vendors claim the laboratory will bear the cost of the interface, but you should check with your primary laboratories/imaging centers on their policies.

Extra costs can be the monthly maintenance fees required for the special interfaces mentioned. the electronic prescribing of drugs option and mobile devices for hospital rounds. Remember to ask if any option has associated extra monthly fees of any kind. A great example is EDI (Electronic Data Interchange), especially if the vendor has its own and its the only option available with the system.

Software, Hardware Network and Office Infrastructure costs. Examples of software items are improved reporting options, accounting applications, system security packages and other software programs. Examples of hardware items are computers, monitors, scanners, printers and other items. Examples of network and office infrastructure are Ethernet cabling, internet devices like modems, routers and switches in addition to internet service provider services. Remember that all of these items carry monthly maintenance fees, too.

The end result is to be informed. Take the time to do your home work to itemize all of the bits and pieces that will all be tied together to make up an EMR/EHR Office Solution System.

Finally, select the components that will be capable to grow with your business over time. This flexibility and ease of upgrading will be essential for future changes to be accomplished with the least impact on your daily operations. The best advice is to break down all of the components of the hardware and software. Engage good advice from experts in the field.  This way you can tackle this project knowing that the job was done right the first time and on time!

When you need proven expertise and performance

Thomas M. Lee, Partner

Mr. Thomas M. Lee has over 35 years of experience in the business of healthcare with special emphasis in operations management, financial analysis, financial forecasting, construction projects, and new program development.

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2 thoughts on “EHR Installation – Surprise Extra Costs

  1. Thank you for your remarks, Art, and for sharing the figures that you’ve laid out on your own blog concerning the cost of WAN for a multi-site medical practice. I guess the overall theme here is that when in the market to acquire and implement an EMR/EHR system that it’s important to be an informed consumer. Early in the process, knowing what questions to ask, and what the operational and financial impact of the choices are will key to making decisions that will lead to a satisfying outcome.