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How to Select an EHR System

These eight steps will ensure that you avoid frustration and wasted money.

SCOT MORRIS, O.D., F.A.A.O.

Selection of an electronic health records (EHR) system is, unfortunately, not quite as simple as choosing a new phone, car or computer. There is a lot to think about before buying something that will revolutionize your practice and change your workflow so dramatically. This column walks you through the electronic health records (EHR) acquisition process by summarizing eight key selection steps. Let me add a word of caution before we start: Please do not take any shortcuts — doing so can result in a great deal of frustration as well as money needlessly spent.

1. Identify daily workflow. Do you understand exactly what happens in your office in terms of daily workflow? You can't determine where you are going if you don't know where you are and what you do currently. How do patients move through your office? What is each step of the process, and what does it entail? The answers to each of these questions will uncover the specific needs unique to your practice.

For example, if you have one computer in your office and it's used solely to access the Web to determine insurance eligibility information, you have very different needs than a practice that uses computers to schedule patients, show educational videos and file claims online. Identify where you use technology in the basic areas of your office, such as financial management, internet accessibility, marketing, scheduling, billing, etc.

2. Involve staff. Examine your workflow, and determine what you could do differently or want to do differently. Ask your key staff members for help since they'll be using the system as often, or more, than you. Including them won't only help with the transition and build up employee morale, but also prevent you from overlooking issues of which you may not be aware.

3. Assess what you need. What do you really need (not want) to operate efficiently? Determine the viability of your current hardware, software and peripherals such as printers, scanners, etc. You'll also need to identify how your EHR will affect your current software. Determine any integration issues, such as a visual field machine or topographer that won't "talk" to certain EHR systems. Does the EHR require any special networking needs, such as new routers or switches?

4. Shop wisely. Keep in mind that while you're shopping for solutions, vendors are in the business of selling software. Rather than just relying on the consultation of a vendor, request a list of their clients, not just the VIP customers but a dozen others. Then, do your homework. Call current customers to find out their experiences with the EHR system. Ask about the good and the bad. You'll likely get a very candid discussion, as well as time-saving tips that they've learned along the way.

5. Evaluate the software. Do the software modules fit your needs? Even if they aren't perfect — are they functional? A basic function checklist includes e-commerce, communication tools, inventory management, coding and insurance features, practice management or business intelligence tools, marketing tools, and the EHR itself.

Ask the vendor for a demo CD of their current system, not the version that "will be coming out shortly." Rather than accept the standard package, ask the vendor for their best offer based on what you need. Lastly, be sure that the vendor clearly explains and documents all the features surrounding support and upgrades.

6. Determine hardware/peripherals. If you need a new server, spend a few bucks, and get what you need. Kim Castleberry, O.D., has developed a great Web site for optometrists (www.eyetechnology forfree.com) that covers various components. Unfortunately, hardware isn't free, but it is getting less expensive. Buy the best you can afford now because information and technology equipment gets outdated quickly. If you're using a hosted solution, you may need to focus more on the connectivity issues than the servers. Be sure you know what you need. If you don't know, ask someone for help.

7. Determine your budget. Review what your hardware needs will be. Have a few local IT companies quote you on what it costs to acquire the hardware, peripherals and networking that you need. Also, obtain an estimate of what they will charge for integration, setup and maintenance.

8. Plan your implementation. Put together a basic timeline for implementation. Ask for help from others who have implemented EHR systems, as well as from the vendor. Make sure the vendor gives you a step-by-step process complete with materials, deadlines and other details that your practice requires. If they can't provide it, tell them they need to develop such a detailed plan before you'll buy their software.

As we'll discuss in future columns, implementation is the most crucial step in a successful EHR launch. If you don't have a plan, you'll have a problem.

Finally, be educated, be aware, and make the right choices. In next month's column, we'll explore how peripheral technology can impact your practice. OM