EHR Replacement and Selection – 4 must answer questions

Woman Doctor using EHR

EHR replacement is one of the most important decisions you make in a medical practice.  There is a reason you are considering a switch to a new electronic health records system.  You need to know what you want the outcome to be . . . a more efficient and result oriented medical office!

The landscape of EHR options and vendors is slowly settling into a recognizable pattern. The EHR market is consolidating, and smaller vendors are fading from relevance.  Applications that integrate practice management functions and electronic health records are rising to the top of the heap.

Electronic Health Record system selection – still challenging

One thing that has not changed is the complexity and challenge of selecting an electronic health record system.  And if you are going through an EHR replacement process, the experience you gained the first time when selecting an EHR system should serve you well.  Despite the consolidation and shakeout, there are still many approaches and many choices within those approaches.  Here is a short list of the alternatives you must sort through.

  1. Will you pursue an integrated system or options where the electronic health record application is separate from the practice management applications like scheduling and billing?
  2. It is possible to get an electronic health record application at no or very low cost.  The catch is you will be strongly tempted to utilize the practice management applications, especially billing.  These applications complement the electronic health record system – and those are not free!  In effect, you may be signing up for a billing/accounts receivable service in order to get scheduling and charge entry functions.
  3. Should you switch to a specialty-specific EHR?  In effect, these applications are already customized for a specialty and may be easier to learn and utilize.  A non-specialty EHR application will require more customization, but of course, is more useful in a multi-speciality environment.
  4. A great many electronic health record systems are cloud-based applications these days.  These systems have an advantage in lower initial costs for software, but may be more expensive over time.  After all, the monthly fee per provider usually continues forever, even though it also covers upgrades.  And don’t forget to make sure your local internet speed will support a cloud-based application.

EHR Replacement – the short list

As you come up to your short list of EHR systems you are considering, start thinking about vendor demonstrations.

  • The vendor you select should be experienced and have a reasonably large customer base.  Most consolidation has taken place among publicly-traded companies.  Be sure to ask about the history of the software: was it part of an acquisition by a larger vendor previously?  If so, does the vendor have competing systems, and will eventually choose to keep one or the other?
  • Make a list of functions you want to see demonstrated, and make sure you see all of them during the demonstration!
  • Does the vendor have experience with EHR replacement?
  • Get some references of other recent installations and call them!  The vendor will most likely give you references who will speak positively about their system.  But you may still learn valuable insights about how the installation process went.  You may also learn about issues that are not directly related to the vendor’s performance, but may affect your selection too.

Implementing your new EHR Replacement system

The EHR selection process is only one of the first steps.  Successful implementation will also require a great deal of attention and care.

  • You must adapt processes in your office to the new applications.  Consider conducting an Operational Analysis of your clinic functions.
  • All applications require “file builds,” where you set up tables for a whole host of parameters that affect your practice.  Scheduling, charges, payor contracts and user roles and privileges are just a few of these items.
  • Training of staff and physicians are extremely involved.  You must set aside enough time to get everyone who will use the system trained, and to test the application before your go-live date.

In a recent EHR replacement consulting engagement, we were able to save $130,000.  Review this case study and be surprised!

In the EHR replacement process, it is useful to think about selecting an electronic health record and practice management system as a one-time event. You do not want to do it again, if at all possible!  So put effort into it just like you would whenever you are making a major decision.  It is not impossible to change electronic health record and practice management systems again.  But, it is almost as traumatic as making the initial selection!  Exercising due diligence will certainly pay off, both in the short and long run!

When you need proven expertise and performance

Jim Hook, MPH

Mr. James D. Hook has over 30 years of healthcare executive management and consulting experience in medical groups, hospitals, IPA’s, MSO’s, and other healthcare organizations.

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