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Since the U.S. government has enforced the EHR mandate under its 21st Century Cures Act 2016, there has been significant growth in the adoption of EHR systems.
However, given the complexity and multifaceted nature of EHRs and the wide range of options available, healthcare professionals find it difficult to select the one that best suits their needs. Moreover, choosing the wrong EHR can negatively impact the operational, financial, and social efficiency of the institutions. For instance, a study showed that implementing a poorly designed EHR increased lengths of stay by an average of 6.3 minutes.
We are here to spread awareness, and in this article, we will examine all the aspects, steps, and reflections that can simplify the EHR selection procedure for you.
In this write-up, you will discover:
Let’s dive in with the very first point.
EHRs store and manage patients’ information in a way that is compliant with HIPAA and HITECH. Their main aim is to secure the exchange of patient data among various providers.
While the purpose of the Practice management system (PMS) is to make practices more efficient. It mainly focuses on the financial and administrative aspects of healthcare institutions.
Though both EHR and PMS work with patient data, they differ in the kind of data they deal with and the benefits they provide.
For instance,
Additionally,
EHR benefits are centered around the clinical side of healthcare practice. Such as, it helps in:
While the benefits offered by PMS are inclined towards the business side of the healthcare practice. It:
“A well-integrated EHR and PMS can reduce the time clinicians spend on paperwork by up to 50%.“
Akhil Singhal
Director
Having a clear understanding of the difference between an EHR and a PMS can profoundly aid you in identifying your specific needs.
For instance, if your institution faces challenges with clinical documentation or care coordination, implementing a robust EHR is crucial. On the other hand, if the primary concerns are operational efficiency or if your organization struggles with cash flow, then focusing on a PMS is essential.
This understanding also empowers you to select an EHR that smoothly integrates with your existing PMS or encourages you to opt for a solution that combines both functionalities.
Here’s how you can identify your specific needs.
Before selecting an EHR system, it is essential to conduct an EHR needs assessment. This enable you to know why your current system isn’t achieving the result you want. Where is the gap? Is it customization, interoperability, security, or compliance? In what ratio are they contributing to your slow growth? What features or functionalities your new EHR system must have or what areas will carry the maximum length and attention when you request a proposal or compare vendors?
You can get the answer in just 3 simple steps.
Step 1: Recognize key stakeholders
Form a team and include members who use your EHR system daily. Their insights are necessary to have a 360-degree view of clinical workflows and requirements. This could be a representative from clinical, administrative, IT, finance, and compliance departments.
Step 2: Analyze your current state
Do it the Socrates way. Ask the right question to the right person. Get started with the below-listed questions.
Step 3: Mark your key performance indicators
Based on the inputs received, clearly mark the goals of EHR implementation, such as prioritizing patient care, increasing efficiency, or ensuring regulatory compliance. Choosing an EHR that offers detailed and easily accessible patient records, facilitates seamless data exchange, uses patient portals to enhance communication, and provides comprehensive training and ongoing support.
“A well-conducted needs assessment can help maximize the return on investment by 10% to 20%.“
Dr. Giriraj
Lead Business Analyst
Now, let’s move on and get familiar with the divergence of EHR systems.
Each type of EHR presents distinct functionalities and characteristics. Recognizing these variations helps tailor them to your particular needs. Furthermore, EHRs come with various deployment models, including cloud-based, hybrid, and on-premises options. The interfaces and integration capabilities also vary significantly. Grasping these aspects not only eases the learning process for your team but also proves to be cost-effective.
Here’s a broader overview of the different types of EHRs and their usability.
Related Read : How EHR Software Empowers Better Patient Care Decisions
It is also known as a client-server EHR, in which the EHR is hosted and managed locally on the practice’s server and computers.
Pros
Cons
In this type of EHR, the vendor uses an external server, commonly known as the cloud, to store, exchange, protect, and manage data. It is easily accessible over the web.
Pros
Cons
“Cloud-based EHRs are a more satisfactory way to reduce medical errors through better data accessibility and real-time updates.“
Health Informatics Team
It doesn’t include details for single-specialty; instead, it caters to multiple-specialty and general practitioners. Presenting a wide range of functionalities and customization options, it can be adapted to meet various clinical and administrative needs.
Pros
Cons
They are precisely built keeping a particular specialty in mind such as Cardiology, dermatology, oncology, etc. Their properties, tools, and workflows are designed to reinforce the exceptional requirements of the specialists, from specialty-specific terminology to specialty-specific documentation.
Pros
Cons
“Specialty-focused EHRs are the best fit for practices with a defined medical specialty.“
Dr. Giriraj
Lead Business Analyst
Post discerning the different types of EHRs, it’s time to dig deeper into their components/offerings and see how they impact a healthcare ecosystem.
Here we go.
Customization
Customization ensures that the system fits the distinctive conditions of your institution instead of you making adjustments. When your team perceives that the functionalities align with their daily routine tasks, they feel more confident about using the software. In the dynamic healthcare landscape, having a knowledge of whether or not the software can accommodate shifting preferences can be a deciding factor in the quality of care provided.
While investigating the customization capabilities, focus on critical elements like pre-built customizable templates, bi-directional e-prescribing, lab orders, and so on.
“Custom templates can reduce the time doctors spend on documentation by up to 30%.“
EHR Implementation Team
Interoperability
Without robust Interoperability, your practice data will be isolated. This will lead to errors and inefficiency as practitioners, administrative staff, and lab technicians find it difficult to access and exchange information.
While exploring interoperability, pay attention to capabilities like semantics, data exchange, and standardization across various healthcare systems.
Scalability
A scalable EHR enables you to expand your services without facing performance issues or slowdowns. With new healthcare changes, investing in a system that can be easily scaled up or down is the need of the hour.
While navigating the nuances of scalability, do not overlook horizontal scaling, load balancing, partitioning, and CDN.
“Scalable EHR systems can increase patient engagement attempts by up to 40%.“
Health IT Analysts Department
Security and Compliance
Patient data includes plenty of sensitive information. Choosing an EHR with powerful security and compliance prevents these details from unauthorized access, data breaches, and cyber-attacks. Additionally, it plays a crucial role in upholding the patient’s trust and the practitioner’s reputation.
To assess the security, look for features like encryption, firewall, and anti-malware protection. For compliance, take note of HIPAA, HITECH, FTC acts, and state laws.
“EHR systems can automatically generate compliance reports for regulatory bodies like HIPAA.“
Indravadan Gohil
Sr. Project Manager
Now, let’s examine some of the time-tested strategies for selecting vendors that best suit your asks.
The quality of the product and service depends on the quality of the vendor you are associated with. A vendor has a direct impact on your institution’s financial, operational, and technical growth. Choosing the right vendor with the right set of experience and experts ensures better collaboration, innovation, and risk sharing. Below are the steps/criteria you can follow while evaluating your vendors.
Initiate with a Google or KLAS Research
You can start with a Google search. Input keywords like ‘Best EHR software’, ‘top EHR systems’, ‘EHR software reviews’ or ‘EHR software list’ to find potential vendors. Visit their websites and read through the kinds of products and services they offer. Pay attention to case studies, experience in healthcare IT solutions, global clients served, and ratings achieved on G2 and Capterra.
To gain more specialized Insights into EHR Software, you can also seek support from KLAS research. They collect direct data from healthcare providers and offer unbiased reviews and ratings on various EHR products/services, their performance, interoperability, customization, client satisfaction, and more. Their detailed reports and analytics are a good way to assess the vendors’ strengths and weaknesses.
“By utilizing existing data, you can avoid the costs associated with trial partnerships.“
Business Intelligence Team
Concentrate on innovative capabilities
Prioritize vendors who are continually exploring new technologies and methodologies to enhance their product offerings. These vendors are more likely to integrate the latest features in their EHR system. Advanced features like AI, machine learning, Telehealth, and telemedicine improve operational efficiency and assist you in making better clinical decisions and delivering more personalized patient care.
You may find the upfront cost charged by a few innovative vendors on the higher side. But in the long term, it saves you costs and time through enhanced performance, zero investment in third-party tools, and the modernization of legacy systems.
“EHR systems utilizing predictive analytics achieve a 25% improvement in patient outcomes.“
Indravadan Gohil
Sr. Project Manager
Peek into their customer support
While selecting a vendor, be cautious about their customer support structure. Do they provide 24/7 multi-channel support? What is their average response and issue resolution rate? A vital customer support system ensures you get assistance whenever you need them.
The best way to investigate a vendor’s customer support system without contacting them is to review their case studies and client testimonials.
“Practices with dedicated EHR customer support experienced 30% less downtime.“
IT Support Specialists
Take a glance at EHR certifications
Before making the final decision, confirm that the vendor is certified by relevant regulatory bodies, such as ONC-ACB certification. Their EHR systems comply with industry standards such as HL7, ICD-10, and SNOMED CT.
These certifications must be considered, as they ensure systems meet stringent standards for functionality, security, and interoperability.
Now, shortlist 2-5 vendors with possible fits and request for proposal (RFP).
Suggested Read : Top 5 EHR Software Features to Improve Clinical Efficiency in 2024A well-structured RFP helps you narrow down the options and select the one that best meets your needs. It invites details from vendors on their offerings and facilitates a comparison of different types of EHRs.
Here’s how you can craft the most appropriate proposal in just 4 simple steps.
Step 1: Start with detailed information about your institution. Explain your organization’s mission, values, and critical healthcare activities. Provide context to your current EHR system and what you want to achieve with the new one. Define the scope of your practice, the specialty, the number of people/departments that will use the EHR, whether your EHR requires integration with other healthcare systems, and so on.
Step 2: Chart out the functions you expect from your new EHR system. List all the functionalities, from reporting functions, security features, patient portal, and ePrescribing to interoperability and end-user training.
Step 3: Be clear about your budget constraints. This will help your vendors assess your project’s financial feasibility and suggest solutions within your financial means. It will also prevent you from wasting time and resources exploring out-of-reach vendors. Moreover, the right vendors often have various customization options. Knowing about the budget will help them scale down unnecessary features and propose a solution that best meets your needs.
Step 4: Mention any other desired information, such as customer support or company culture, case studies, references, experience, expertise, anticipated project start date, RFP submission deadline, or selection steps.
“The RFP shouldn’t be so detailed that it hampers the vendors’ ingenuity or so vague that the vendor is left stuck. Maintain a balance.“
Kamal Sharma
Project Manager
Last but not least, evaluate proposals by EHR functionality, calculate ROIs, schedule demos with the top 2-5 EHR vendors, and partner with the one that resonates most with your envisioned solution.
Use the template below to get your top 3 vendors.
| Parameter | Vendor A | Vendor B | Vendor C | Score % |
| Customization | ✔✔ | ✔✔✔ | ✔✔ | |
| Interoperability | ✔✔✔ | ✔✔ | ✔✔✔ | |
| Scalability | ✔✔ | ✔✔✔ | ✔✔ | |
| Security and Compliance | ✔✔✔ | ✔✔ | ✔✔ | |
| User Interface | ✔✔ | ✔✔✔ | ✔✔ | |
| Customer Support | ✔✔✔ | ✔✔ | ✔✔✔ | |
| Onboarding Time | ✔✔ | ✔✔✔ | ✔✔ | |
| Cost | ✔✔ | ✔✔✔ | ✔✔ | |
| References and Reviews | ✔✔✔ | ✔✔ | ✔✔ | |
| Innovation and Updates | ✔✔✔ | ✔✔ | ✔✔ | |
| Vendor Experience | ✔✔ | ✔✔✔ | ✔✔ | |
| Integration with Existing Systems | ✔✔✔ | ✔✔ | ✔✔ | |
| Certifications | ✔✔✔ | ✔✔ | ✔✔ | |
| Data Migration Support | ✔✔ | ✔✔✔ | ✔✔ | |
| Performance and Reliability | ✔✔✔ | ✔✔ | ✔✔ | |
| Training and Resources | ✔✔ | ✔✔✔ | ✔✔ | |
| User Feedback | ✔✔✔ | ✔✔ | ✔✔ |
Scoring Keys
✔✔✔ = Excellent
✔✔ = Good
✔ = Fair
Usage Instructions
Choosing the right EHR system is a strategic decision that is more about envisioning a future where data flows seamlessly across platforms, and patients receive personalized, timely, and efficient care. This decision requires a thorough assessment, considering not just the immediate functional requirements but also long-term goals.
