An effective EHR selection process is crucial for healthcare organizations to mitigate the challenges that may arise from a flawed approach. These challenges encompass reduced productivity, poor user satisfaction, administrative inefficiency, and compromised quality of patient care. Moreover, selecting an unsuitable EHR product can lead to functional problems in care delivery and business management, as well as short-term and long-term financial costs. However, take solace in the fact that many have gone through this process before, and you can benefit from their hindsight. By following this outlined process, you can make an informed decision in choosing a a new system or EHR that best aligns with your organization’s strategy and goals.
The suitability of an Electronic Health Record (EHR) for a medical practice hinges on aligning the software’s functionality and features with the practice’s specific requirements. Selecting an ill-suited EHR product not only leads to reduced efficiency and quality of care, but also detrimentally affects the satisfaction levels of clinicians and administrative staff. Notably, a survey conducted by the KLAS research agency, comprising various EHR satisfaction surveys, discovered that 70% of the disparity in satisfaction between different organizations can be attributed to factors like training, trust in IT, and the degree of which EHR features and personalization.
Significantly, achieving optimal levels of EHR personalization necessitates an effective selection process that can accurately ascertain a practice’s health information technology needs and identify a product that aligns with those requirements. The critical bridge between a practice’s needs and a product that meets those needs hinges on authoritative and actionable information.
Formulating a successful vendor selection process commences with a foundation of reliable and actionable information. Reliable information from vendors and stakeholders provides a comprehensive view for the selection team to assess organizational requirements and vendor product alignment. On the other hand, actionable information enables the the selection committee team to make informed decisions based on practical insights.
Nevertheless, obtaining both reliable and actionable information necessitates an understanding of where to acquire such data, as well as the subsequent collection and analysis of the information. Unfortunately, selection teams often overlook or fail to execute this crucial aspect, leading to serious consequences like low EHR satisfaction, decreased productivity, and inefficiency.
To accomplish the objective of acquiring reliable and actionable information, it is important to leverage an organization’s human resources. Valuable insight and pertinent information that can guide the selection process are often found in the individuals who provide care and manage administrative functions within the organization. These key stakeholders possess significant knowledge about the features and requirements necessary for healthcare providers to deliver quality care in an efficient manner, making their involvement essential.
Assess the current EHR system at your organization
When it comes to migrating medical data over from an old Electronic Health Record (EHR) to a new one, the process is not without its challenges. To ensure a smooth transition, it is crucial to take a step back and conduct a thorough evaluation of your existing EHR. Assess if it aligns with the evolving needs of your medical practice. A fundamental question to ask yourself is, “Does my current EHR truly enhance the efficiency of our practice?”
Once you have fully implemented an EHR, it becomes imperative to gauge its impact on efficiency and ease of management in day-to-day operations. If you fail to witness a significant improvement, it may be time to explore alternative solutions. Consider the following questions in your assessment:
- Is it sufficiently flexible to adapt to changing demands?
- Does it provide robust data security measures?
- How frequently does it perform backups?
- Are regular updates part of its regimen?
- Does the EHR offer comprehensive support to meet the needs of your staff?
During the onboarding phase, it is essential that both physicians and other medical staff seamlessly navigate the EHR system. An effective EHR should not only streamline processes but also enhance productivity and boost employee morale. By automating manual tasks, the best EHR system becomes a catalyst for improved outcomes and overall practice efficiency.
When facing persistent technical glitches and operational disruptions in your current electronic health record (EHR) system, it may be time to reassess its effectiveness. Holding onto a solution that demands ongoing maintenance and error correction not only squanders valuable resources but also jeopardizes the efficiency of your workflows
Consider these additional questions:
- How frequently do you seek assistance from your EHR vendor? Does it impede your daily operations?
- What is the average resolution time for vendor-related issues?
- Is the vendor support provided free of charge, or is it an annual subscription?
- Does the support encompass comprehensive assistance through phone calls? How would you rate its quality?
- Are there supplemental resources available on the vendor’s website, such as videos, forums, or webinars?
By approaching these aspects with a scientific mindset, you can enhance patient engagement and make informed decisions regarding your to select an EHR system.
Are there interoperability issues w.r.t my current EHR system?
Interoperability concerns may arise when it comes to EHR systems. Compatibility issues can occur when integrating various software, such as practice management systems, public health registries, and billing systems. Even if compatibility is achieved, it’s crucial to consider data security concerns. Moreover, as your practice evolves, your current EHR may no longer meet your expanding needs. In light of these factors, it may be time to explore a new EHR solution.
Is my EHR system up-to-date with certifications?
Another aspect to consider is the certification status of your EHR. EHR systems typically have a lifespan of 10 years or more, but industry certification standards are subject to change. To ensure your EHR remains up-to-date, it should meet the following criteria:
- HIPAA compliance
- Meaningful use stage 1 and stage 2 compliance
- MACRA compliance
By addressing these aspects, you can foster greater health system efficiency and advancement within your medical practice.
Gather Clear and Critical Practice Requirements w.r.t your EHR System
The initial and paramount step entails assessing the current magnitude and envisioned objectives of your patient health information and practice. While doing so, carefully consider the EHR’s capacity for daily patient processing, taking into account any existing inefficiencies within the practice. Reflect upon these inquiries to guide your decision-making:
- Will my EHR align with the anticipated demands of the practice?
- What is the optimal number of patients it should proficiently handle each day?
- What is your budgetary allocation?
- What is the expected timeline for integration?
To effectively identify the desired features for your new Electronic Health Record (EHR) system, it is crucial to deviate from the traditional approach of simply creating a software vendor shortlist. By following a more strategic and scientific method, you can ensure a comprehensive and accurate representation of your patient population and practice requirements.
Here’s a step-by-step guide to enhance your requirements gathering process:
- Segment User Groups: Start by identifying user groups from various stakeholder disciplines, such as lab analysts and physicians.
- Conduct Process Audits: Engage each user group in process audits to gain insights into their workflows and identify areas for improvement.
- Map Critical Processes: Thoroughly map out critical processes, both electronic and otherwise, to understand their intricacies and potential bottlenecks.
- Identify Bottlenecks: Analyze the processes you mapped out and pinpoint the bottlenecks that hinder productivity. Categorize these bottlenecks as software, hardware, or user-based.
- Create EHR Requirements: Collaborate with relevant advocates from each department to develop specific requirements that address the identified bottlenecks.
- Seek Approval: Present the compiled requirements list to key stakeholders, such as C-level executives and MU-managers, for review and approval.
- Obtain Unbiased Requirements: By adhering to this comprehensive process, you can eliminate “product bias” and ensure that your requirements list truly represents the needs of your practice.
Failing to follow this scientific approach could lead to an extensive list of requirements, comparable in length to the vast ICD-10 codes.
Identify the Key Decision Makers involved in the EHR Selection Process
The selection of a committee to advocate for the interests of all parties involved in utilizing the same Electronic Health Record system (EHR) assumes critical importance. While the task of selecting practice management software may be entrusted to management alone, the process of choosing an EHR must be led by physicians, who possess invaluable expertise in this domain.
Consider designating a “physician champion” who will conduct comprehensive research on various EHR systems and advocate for their adoption among colleagues. Given the typical resistance and skepticism associated with implementing a new EHR, it is wise to include influential stakeholders in the committee. This entails appointing, at least one physician or manager or their designated representative, a highly esteemed nurse who commands the respect of others, and even inviting individuals who may harbor reservations towards adopting a new EHR to participate in the selection process. By embracing these measures, we can ensure a smooth and timely implementation of the chosen EHR system while fostering a sense of engagement within the organization.
Hence to successfully execute this process, a collaborative team with expertise in practice and process is essential. The team should consist of the following key roles:
- Project Manager: A skilled candidate invested in thorough research and implementation.
- C-Level Sponsor: The authoritative voice of senior management.
- Physician Advocate: Represents physicians during requirements and shortlisting processes.
- Nurse Advocate: Represents nurses during requirements and shortlisting processes.
- Billing Advocate: Represents the billing department during requirements and shortlisting processes.
- Administrative Advocate: Represents the practice management team during requirements and shortlisting processes.
- Meaningful-Use Manager: Required if MU attestation will influence requirements.
- Marketing Manager: Provides valuable insights on communications and user adoption.
In addition to these team members, task your advocates with creating representative user groups from the relevant stakeholder disciplines. By employing this engaging and scientifically-grounded approach, you will ensure the success of your process.
Conduct an In-Depth and Thorough Needs Analysis
For larger medical practices, the next crucial step in the EHR selection and implementation process is to solicit feature requests from various departments for their new Electronic Health Record (EHR). These requests can be categorized into three groups: must-have, good to have, and not required.
Furthermore, actively involving all departments in the EHR selection process by reaching out to team members is an effective approach. This inclusive approach fosters commitment and receptiveness towards adopting the new EHR. Once the responses are compiled, the next phase of decision making process involves preparing the request for proposal, which sets the stage for further advancements.
While identifying the desired features, it is important to consider common elements inherent in top-tier EHR suites:
- Intelligent Patient Workflows: The finest EHR solutions utilize cutting-edge technology to streamline and manage patient workflows in real-time.
- Task Management Capabilities: Efficiently handle daily tasks such as reviewing laboratory results, signing notes, addressing patient messages, and approving medications.
- Intuitive Patient Scheduling: EHR systems should provide robust appointment scheduling capabilities to efficiently register and schedule patients.
- Enhanced Patient Encounters: Facilitate quick access to patient histories and enable users to efficiently record clinical content, including medical abnormalities. This seamless accessibility helps reduce costs and transcription times.
- Pre-Built Templates: Templates are indispensable for efficiently treating patients with similar conditions, saving time and enhancing clinical efficacy. Solutions should include recording patient allergies, medications, immunizations, and other relevant data points.
- Supports Meaningful Use Reporting: Enables access to financial and clinical data for informed decision-making.
- User-Friendly Interface: An intuitive EHR interface should ensure easy accessibility and minimal clicks, enabling users to navigate seamlessly.
- Cross-Device Accessibility: A state-of-the-art EHR should be accessible from various operating systems and devices, facilitating convenient access anytime, anywhere.
Create a budget to meet EHR Solution Requirements
To effectively deliver on requirements, it is crucial to outline a meticulously planned budget. Having a comprehensive requirements list in place allows you to accurately forecast the financial resources needed to meet those requirements.
Now, let’s divert our attention to the finance department for a moment.
The total cost of of Electronic Health Record (EHR) software can vary significantly based on various factors. Based on industry data, the cost range is estimated to be between $15,000 to $162,000. However, recent research suggests an average cost of about $6,200 per user over a five-year period. Unfortunately, determining the actual cost of EHR software is not a straightforward answer as it depends on several factors. Let’s delve into the reasons why.
Here are some influential factors that impact the future costs and cost of EHR:
- Choice of platform, such as Software as a Service (SaaS) vs. perpetual license
- Number of users
- Reliance on external consultancy
- Training requirements for both existing and new staff
- Security audits
The good news is that these costs are often proportional to the scale of your practice. Furthermore, making informed decisions can help reduce upfront costs. By using current and future costs and considering these factors carefully, you can engage in a more scientific approach to budgeting for EHR software.
Carefully Choose RFP Recipients during the EHR selection process
With over 200 vendors in the EHR market, the challenge lies in selecting the right recipient(s) for your RFP. To ensure a successful match, consider evaluating vendors with the following parameters:
Compatibility with Current Systems:
- Is the EHR compatible with your practice management system and medical billing system?
- Seamless data sharing between EHR and practice management systems minimizes redundant data entry.
- Ensuring software interoperability and employee cooperation is key.
- Query your provider about which EHR works best with their practice management system.
By following these guidelines, you can create an engaging and scientifically backed RFP that will help you identify the most suitable EHR vendors for your practice.
Vendors target their products towards small, medium, and large practices, with a select few catering to all sizes. This streamlined approach can save you valuable time during the selection process, as it filters out electronic health records (EHRs) that are incompatible with the size and needs of your practice.
Once you have sent out your request for proposals (RFPs) and received responses, it is crucial to assess and rank the vendors based on how well they align with your requirements. Here are some scientific methods you can employ to evaluate potential vendors:
- Implementation: Evaluate the time required for EHR implementation and the impact on workflow. Does the EHR seamlessly integrate with billing systems, practice management systems, and public health registries?
- Customization: Assess the ability to customize the EHR to accommodate various medical specialties. Can the dashboards be tailored to meet your practice’s unique requirements?
- Customer Service, Training, and Support: Examine the availability of 24/7 customer care. How promptly do they respond to emails? Check if they offer comprehensive training videos, user manuals, and on-site support. Consider the associated costs as well.
- Technology: Determine whether the EHR is web-based, cloud-based, or software-as-a-service (SaaS). Additionally, assess if it necessitates the purchase of new hardware.
- Security and Backups: Inquire about the data storage location and the encryption methods employed. Understand the frequency of automatic system backups.
- Affordability: Evaluate the initial cost, license renewal frequency, overall software expenses, payment schedule, and upgrade costs.
Based on the aforementioned criteria, you easily rank your vendors and shortlist approximately six to ten contenders for further consideration.
Attending Vendor Demos has always been a crucial part of the EHR selection process
After ranking vendors based on their alignment with your requirements, attending vendor demonstrations is the next step. Demos provide insight into the vendor’s operations, work culture, and financial stability. Site visits allow you to witness system performance by observing practices similar to your own in size and type that utilize the same practice management software. These visits should be made with at least one physician and one decision maker, dedicating a day to observing patients.
Final Step of the EHR selection process: Decision Making & Contract Negotiation
After each site visit, review vendor rankings. Select two vendors to negotiate with. If negotiations go poorly with the winner, consult the next vendor. Involve other stakeholders if you are in a large practice. Invite vendors to present demos and answer questions about the EHR. Inquire about costs and payment schedule, including after the initial contract period. Consider legal advice for software contract matters. Selecting a new EHR is not easy, but it’s crucial for efficiency and revenue. Being methodical and careful at every step is key.