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Choosing the Right EHR System for Your Medical Practice

Choosing the Right EHR System for Your Medical Practice
Credit: Guschenkova/Shutterstock

In the modern age, electronic health records (EHR) systems are an essential component to any medical practice. With the right EHR system, your practice will become more efficient, eligible to collect Medicare incentive payments, and communicate seamlessly with patients and other members of the wider healthcare ecosystem.

However, finding the right system is no easy task. Whether you're switching to a new EHR or are implementing one for the first time, it can be a daunting selection. The systems are complex and multi-faceted, making it hard to fully test drive one before making a choice. However, there are ways to whittle down the candidates until you're left with only the best. 

Here's everything you need to know to find out which one is right for you.

Already know all about Electronic Health Records Systems? See our 2018 recommendations for the best EHR systems for small practices and specialists.

Although the terms are often used interchangeably, there is a big difference between electronic medical records (EMR), which are essentially just digitized paper charts for a single practice, and EHR systems. For one, EHRs not only replace paper charts, but can also streamline critical functions like billing, ordering prescriptions and tests, managing your practice, and communicating with your patients. 

The advantage of an EHR system is that everything appears in one place – from a patient's entire medical history to the logistical aspects of running your practice. Even better, EHR systems allow providers at all points of care to communicate with one another electronically; so, if a patient visits the hospital on Saturday, their general practitioner will know exactly what happened on Monday. Physicians and staff can use an EHR system to deliver more effective treatment and create more comprehensive health records that circulate across every point of care. 

Editor's Note: Looking for an electronic health records system for your medical practice? If you're looking for information to help you choose the one that's right for you, use the questionnaire below to have our sister site, BuyerZone, provide you with information from a variety of vendors for free.

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While the benefits of a well-functioning EHR system are clear, implementing and adapting to an EHR system can be challenging for everyone at your practice. Before you commit to any one EHR system, it's important to consider what your priorities are. 

"You have to get all your employees in different departments to have input from all areas of the practice or [EHR implementation] will not be successful," Pam Wilcox, an administrator at Vancouver Eye Care, told Business News Daily.

That's because EHR's don't just impact physicians, but every facet of the practice, Wilcox said. This is especially true when a practice management system or revenue cycle management is integrated with the system. Everyone in the practice should be familiar with implementation goals and a long-term strategy.

It's also important to fully explore your options before making any decisions. Shop around, said Denise Colon, a consultant that's been advising on EMR and EHR adoption for 25 years. Getting multiple estimates, investigating a vendor's reputation and seeking recommendations is always a wise move.

"A number of hospitals start with one EHR and invest a lot of money, but then they start checking around and find out another system is better suited for their facility," she said. "So they literally have to trash the first system … it's just a foolish waste of money."

And while you're required by the Health Insurance Portability and Accountability Act (HIPAA) to ensure patient data in any EHR system is secure, there are also a lot of other things to consider when choosing an EHR system. Here are a few:

Cost: The prices of EHR systems are highly variable based on what features you choose to include, the vendor you select, and how many providers are in your practice. When requesting an estimate, it's important to find out what the initial licensing or activation costs are and how much each additional component (such as a practice management system) will add to the price. Typically, for smaller practices, the price is based on a monthly subscription fee multiplied by the number of providers using the system. For our recommendations, subscription costs range from absolutely free to $750 per month per provider after activation or licensing costs. Those fees generally cost a few thousand dollars. Pricing always fluctuates based on the specifics of each practice and will be determined in consultation with the vendor. 

Ease of use: Perhaps the most important aspect of an EHR system is how easy it is to use. If a system isn't intuitive, it can grind your workflow to a halt as your staff struggles to accomplish routine tasks. Most vendors offer free trials or live demonstrations of their systems to prospective buyers, so take advantage of these options to really evaluate whether you think the system would be a benefit or a detriment to your practice. Remember, you will use this system every day, so you don't want one that will take you away from your patients or add hours of time to your daily workload. 

Cloud-based hosting: Most major EHR vendors offer a cloud-hosting option, meaning there are no servers or hardware to maintain in your office besides your own computers. Cloud-hosted systems provide a relatively cheap way to outsource the costs of IT maintenance and technical support to the vendor. 

Implementation and training: Implementation can take anywhere from a few weeks to a couple of months, so it's important to know what your vendor's plan is when it comes to getting your system up and running. In addition, some vendors offer physician and staff training to make sure everyone in your practice is up to speed with the new software. Occasionally, a vendor will offer one-on-one support for a limited time after the system is implemented at no extra cost. 

"Implementation training is a huge part," Colon said. "Plan it so that training doesn't proceed actual go-live date by too much … or everyone will forget what they learned. Once you do go live, you need adequate support at least for the first week or two so you have support right there when you're live and on the job. Things will come up that you can't anticipate."

Integration: If you're not planning to buy new practice management or billing software, then you'll want to be sure the EHR system you choose can work with what you're already running. Otherwise, many vendors offer their own integrated systems at an additional fee, so if you're starting from scratch it might be worth asking about an integrated practice management/EHR system. 

Interoperability: Some useful features that EHRs offer include e-prescribing and electronically ordering laboratory tests and results. However, not every lab and pharmacy will be configured to interface properly with every EHR system. To ensure you can actually achieve interoperability, which will be a focus of the government's upcoming Meaningful Use Stage 3 regulations, talk to vendors about which interfaces they employ and whether or not those are compatible with the surrounding facilities in your area. 

Customer service: Getting acclimated to a new EHR system is no small task, so you'll want to be sure the vendor will be there to support you along the way. If their customer service is difficult to reach or not particularly eager to spend time answering your questions before you buy, they might not be very helpful when you're trying to figure out your new system later. Establishing a good working relationship with the vendor you choose is key to a successful transition to a new EHR system. 

Meaningful Use certified/ICD-10 ready: Most EHR systems are compliant with the federal Meaningful Use standards that are in place to determine whether an EHR system can qualify for government incentives. It's important to make sure this is the case if you plan to attest for the Medicare incentive program. If the system you choose falls short and you move forward with the attestation process, you might end up facing reimbursement penalties, rather than incentive payments. Also, the change from ICD-9 diagnostic codes to the much more comprehensive ICD-10 means it's important to know if your system is ready. If your system sends payers invalid ICD-10 codes, it could result in rejections. 

Editor's Note: Looking for an electronic health records system for your medical practice? If you're looking for information to help you choose the one that's right for you, use the questionnaire below to have our sister site, BuyerZone, provide you with information from a variety of vendors for free.

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Adam C. Uzialko

Adam received his Bachelor's degree in Political Science and Journalism & Media Studies at Rutgers University. He worked for a local newspaper and freelanced for several publications after graduating college. He can be reached by email, or follow him on Twitter.