Electronic Health Records Program: Choosing the Right Solution

Written by: Cheryl Reifsnyder, PhD and Maya Javorski

Choosing an electronic health records (EHR) program can be a difficult decision for your practice. Whether you have one provider or a team of fifty, effectively collecting and managing patient data is important for providing the best patient care.

An EHR stores a patient's medical data in one software system, offering a comprehensive view of their health profile. The EHR system best suited to your unique practice needs may not necessarily be the most popular or widely used. That is why it's so important to understand the steps involved in evaluating multiple vendors. To select the best technology suite, including the best EHR, for your practice, there are 4 key steps to keep in mind:

1. Prioritize planning.
2. Consider data storage capabilities.
3. Compare vendor options.
4. Explore product demonstrations and references.

These four steps will help you make an informed decision so you can identify the technology best suited to your practice needs.

Step 1. Prioritize planning for your EHR program

Planning is a critical first step when selecting a new EHR-and effective planning requires a thorough understanding of your practice's needs for the new system. Before you can start considering specific products or product vendors, it is crucial to gather input from all relevant stakeholders. Ask questions such as: What are the strengths and weaknesses of the current EHR and/or practice management system? What features and functionalities will be essential in a new system?

Evaluating your current system with practice stakeholders should enable you to identify current functionality gaps so the new system can address specific areas of need. "Areas of need" could range from improving efficiency to enhancing patient engagement. These will provide you with key requirements to use during the selection process.

Another crucial planning consideration is how you will actually integrate the new EHR with your current system. should enable you to identify current functionality gaps so the new system can address specific areas of need. "Areas of need" could range from improving efficiency to enhancing patient engagement.How prepared is your practice to implement a new EHR system, once selected? Do you have the right training, resources, and time to ensure a seamless integration? Many EHRs require a learning curve of some sort; with thorough planning, you can help ensure a smooth transition process.

Finally, patient confidentiality and privacy are some of the biggest concerns when transitioning to a new EHR system. A study on an EHR implementation at a First Nations health center in British Columbia, Canada, found that "Privacy and confidentiality emerged as the most important issue to address in order to secure approval for the EMR… It is therefore a recommendation that privacy and confidentiality matters be introduced early in the planning processes."

Step 2. Consider data storage

Having evaluated your current systems and identified potential areas for improvement, the next critical step is to consider the optimal data storage solution for your new EHR implementation. When selecting data storage, there are two main options: online, remotely hosted versus in-house, physician-hosted data storage. What are the differences?

• A physician-hosted data storage system stores data on servers located on-site.
• An online, remotely hosted data storage system stores data off site, on another entity's server.

Both onsite and remotely-hosted data storage systems have advantages and disadvantages to consider when deciding which type would be best for your practice. On-site data storage places a much greater technical burden on the practice, which will need to determine the exact system requirements for running a reliable local EHR. Operating an onsite data storage facility requires you to procure a sufficient number of servers, storage area networks, network infrastructure, and so on, as well as sufficient server room space to house the required equipment.

Onsite data storage systems will only be as reliable as the resources in place to deal with issues, requiring you to have team members available to provide support in the event that local EHR servers stop functioning. On the other hand, these costs will be easier to estimate accurately, as the practice will be directly responsible for purchasing equipment and paying employees.

Remote-hosted data storage is usually provided by a vendor with server farms and dedicated teams of engineers and technicians to maintain the network infrastructure and deal with any problems. As a result, remote-hosted systems are frequently more reliable than onsite data storage systems, with more uptime overall and greater staff coverage in case any issues do arise. In addition, moving to a remote-hosted system can save the physical space required to house servers and cut costs such as air conditioning, electricity, and the server equipment onsite data storage requires.

Consider data ownership when weighing your options. Understanding who owns the data is crucial for retaining access to past data or integrating with a different EHR system if your contract ends. You should also give thought to operational challenges. System crashes or inaccuracies could pose significant risks of regulatory noncompliance and potential legal liabilities.

Under the learned intermediary legal theory, "Physicians rather than vendors are responsible for identifying errors that could lead to patient harm. System failure is an operational concern that may render physicians unable to respond quickly and effectively to recover data when it is most needed." Careful consideration of data storage options is essential to ensure data accessibility and operational reliability for your practice's long-term success.

Step 3. Consider vendor options

After you have identified your practice's EHR requirements for functionality and data storage, you're ready to begin considering your options for EHR vendors. As you do so, one important consideration is to ensure their system capabilities align with the size of your practice. Small practices often benefit from streamlined, cost-effective solutions, whereas larger practices or health systems necessitate robust systems capable of managing extensive data volumes.

After identifying vendors that cater to your practice size, analyze your functionality needs. Ranking these needs from most to least important helps to narrow down your choices. For example, a patient web portal may be more critical than remote access. Ensure that these functions are user-friendly to enhance efficiency.

Because the healthcare industry is constantly evolving, your vendor should be able to adapt to ongoing changes. Avoid the mistake of choosing a vendor whose system has not kept pace with new healthcare regulations and standards. Verify the vendor's compliance by checking the Certified Health IT Product List (CHPL), which ensures their products meet stringent criteria and regulatory requirements. This verification ensures the EHR system is reliable and compliant with evolving industry standards.

Additionally, consider cost implications carefully. Clarify that there are no hidden start-up fees or unexpected costs that could arise after signing the contract.

If interested in a free trial, confirm that there are no strings attached after the trial is over. A risk-free trial would be the best option. A vendor who is fully transparent with their pricing up front is more likely to establish a trustworthy partnership.

Step 4. Explore demonstrations and references

Now that you have narrowed down your vendor options, it is time to request demonstrations of the EHR software. The visual demonstration should cover consistent clinical scenarios relevant to your practice.

During these demonstrations, you should also be asking about customer training and support. Understand their procedures for system downtime, training protocols, and ongoing support to optimize your use of the EHR. A reliable support team is crucial for navigating challenges effectively and maximizing the benefits of your EHR system.

Beyond these visual walkthroughs, consider submitting a Request for Proposal(RFP) to understand, define, and document your requirements. RFPs are commonly used for complex IT (Information Technology) projects.

In addition to evaluating the vendor directly, seek feedback through word-of-mouth, contacting references, and online reviews. If possible, arrange for site visits to healthcare practices currently using the vendor's EHR system. Observing the system in action and speaking directly with users can provide valuable insights.

The greater the number of sources, the more comprehensive the information. After carefully checking the contracts from your vendors and you are satisfied with your evaluation, you are prepared to choose your EHR vendor.

Leading your EHR program to success

Selecting the EHR solution is crucial for improving patient care quality and efficiency in your medical practice. Your EHR selection should leave you eager to see improvement within your practice. It involves meticulous planning, careful consideration of data storage options, and thorough evaluation of vendor capabilities.

Here at Veradigm, we understand these complexities and are committed to guiding you toward a successful EHR implementation.

We offer tailored solutions that cater to practices ranging from solo practitioners all the way to large multispecialty clinics. Our EHR systems are customizable and user-friendly, catering to diverse levels of experience and specific practice needs. Not only do we integrate with existing systems but also with hundreds of certified applications familiar to clinicians.

Still concerned about transitioning to a new system? Our customer support experts provide timely assistance and prioritize secure and compliant software. With multiple EHR solutions, we have something for everyone. Choose Veradigm the modern healthcare environment.

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