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Choosing the Right EMR System: A Buyer's Guide

Choosing the Right EMR System: A Buyer's Guide
Credit: Guschenkova/Shutterstock

Electronic medical records (EMR) systems are no longer luxuries. Healthcare providers that want to provide a modern standard of care to their patients, not to mention avoiding government penalties, have no choice but to implement a Meaningful Use-certified EMR system.

Complaints abound about clunky implementation processes and unreliable systems, but with the right EMR system, healthcare providers can offer more efficient, quality care and build a complete, communicable patient profile that follows them through all points of care.

Finding the right system is no easy task. Whether you're switching to a new EMR or implementing one for the first time, it can be a daunting selection. The systems are complex and multifaceted, 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.

There is technically a difference between EMRs, which are essentially just digitized paper charts for a single practice, and electronic health record (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. However, members of the industry often use the terms EMR and EHR interchangeably, and so for the ease of our readers we've chosen to use them interchangeably as well.

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. 

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

It's also important to fully explore your options before making any decisions. Shop around. Getting multiple estimates, investigating a vendor's reputation and seeking recommendations is always a wise move.

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 a lot of other things to consider when choosing an EHR system. Here are a few.

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 $150 to $1,100 per month per provider after activation or licensing costs. Those fees generally cost a few hundred to a few thousand dollars. Pricing always fluctuates based on the specifics of each practice and will be determined in consultation with the vendor. 

Perhaps the most important aspect of an EMR 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 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. And ease of use doesn't end at the provider; office staff and billing managers also need to be trained on the system and find it easy to understand and engage.

Most major EHR vendors offer a cloud-hosted 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. For medical practices, we recommend a cloud-based option unless you have a specific reason to host servers onsite.

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 for 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. 

Some useful features that EHRs offer include e-prescribing and electronically ordering laboratory tests and results. However, not every lab, hospital and pharmacy will be configured to interface properly with every EHR system. To ensure interoperability, which is a primary focus of the government's Meaningful Use Stage III guidelines, talk to vendors about which interfaces they employ and whether or not those are compatible with the surrounding facilities in your area. Many vendors are willing to build out additional integrations upon request, so find out if this is possible and if it would be included in your subscription costs.

Getting acclimated to a new EMR system is no small task, so you'll want to be sure the vendor will be there to support you along the way. If its customer service is difficult to reach or not particularly eager to answer your questions before you buy, the service 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 EMR system. 

Most EHR systems comply with the federal Meaningful Use standards that determine whether an EHR system achieves its purpose of being communicative and effective. If the system you choose falls short and you move forward with the attestation process, you might end up facing reimbursement penalties. Also, the recent 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. ICD-10 has been an established standard long enough that a reliable EHR vendor has had plenty of time to ensure coding is working properly and make the necessary updates.

Ready to choose an EHR system? Here's a breakdown of our complete coverage:

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.