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Choosing the Right EHR: A Quick Primer

Selecting an EHR is not an easy task. It’s a long term investment that entails a lot of daily use and ongoing problem solving.

Choosing the Right EHR: A Quick Primer

By Vlad Hurduc

Selecting an EHR is not an easy task. It’s a long term investment that entails a lot of daily use and ongoing problem solving. A good EHR will significantly improve clinic efficiency and profitability, but a bad one will slow down your pace and burden you with unexpected expenses. Choosing the right EHR can be an intimidating prospect, but with the right information you’ll be able to make the right choice.

We’ve been in the trade for over ten years, and have fielded thousands of questions from physicians enquiring about our Urology EHR, so we decided to compile this quick primer using client questions. We’ve divided our evaluation into four categories: Functionality, Usability, Support and Cost. To make the guide brief and efficient we omitted the obligatory ONC certification and HIPAA compliance. Readers are encouraged to ask and familiarize themselves with HIPAA and ONC certification.

Functionality

The first important factor to consider when purchasing an EHR is functionality. Our analysis found 15 key features in this area. They include the speed and effectiveness with which a doctor can view information without missing anything, visit documentation, test orders, writing prescriptions, communication with referring physicians, and correct coding and same-day billing. Below is the full list of key features, explained. Does the EHR perform the following tasks effectively?

Chart Review Lists the reason for a patient’s visit, problem list, meds list, test results, and other information without the "noise" of too much data
Quick Documentation Documents the visit and the process of decision-making quickly time wasted in the process
Presence of Alerts Identifies clinical issues by means of alerts and reminders
Decision Support Helps you to make clinical decisions based on support from specific knowledge references
ePrescription ePrescribes and transmits scripts and refills to pharmacies electronically
ICD-10 Dual codes automatically, using built-in crosswalks
Orders Efficiently orders labs, imaging, and other investigations
Visit Notes Communicates electronically with referring providers Exchanges information with patients and limits patient communications to clinically relevant information
Billing Automatically matches ICD and CPT codes to the patient's visit data and helps with E&M coding to ensure compliance
Reduce Denials Improves collections and reduces the burden of denials and rebilling
Compliance Assists providers to automatically comply with payer rules and with privacy, consent and HIPPA
Registry and Recall Has the ability to add patients to a registry or to a recall list for efficient follow-up
Visual Review Displays pieces of data in longitudinal arrays for easy review and graphing
Reporting Is able to query the database to produce both individual and group reports on clinical and financial issues
Interface Interfaces information with labs and hospitals via electronic orders and results
Smart Learning System Software that improves with usage; it learns where data and alerts are organized based on user utilization. It "learns" the user.

Usability

The next key factor is usability. Below is a list of five usability elements, ranging from navigation to minimal cognitive load. Does the EHR do all or some of these?

Input Methods Inputs information using a variety of methods like keyboard, mouse, pen, and speech software
Customization Customizes the sequence tasks, and screens to suit personal work flow
Ease of Learning Quickly learns the menu categories, graphics, icons, and symbols so time is not wasted in recalling functionality
Integration Seamlessly integrates with other systems where needed (payers, clearing houses and others)
Accessibility and Mobility The EHR system can be accessed remotely, and can be used on mobile devices to chart, view histories, document visits, and capture charges

Support

Another important category to consider is support. How easily can providers, office managers, and other clinical staff get help when problems arise? We found the following three points to be the most critical.

Quickly accessible Helps with questions quickly
Upgrades Makes software upgrades available as needed
US Based Customers can easily explain any issue and understand the response

Cost

Finally, the issue of cost cannot be overlooked. Does the product offer good quality at an affordable price?

Affordability Is the software affordably priced? Cloud-based?
Pricing Flexibility Is there is flexibility in the terms of pricing and payment?
Modular Pricing Are you only paying for what you need?
No Hidden Costs No hidden charges spring up unexpectedly.

Despite the variety of factors to consider, don’t feel intimidated or overwhelmed. With so many great technological innovations in the last few years, we believe that now is better than ever to purchase an EHR. Newer EHR vendors go to great lengths to showcase their EHR software, so it is relatively easy to compare different offerings - you can almost think of EHR vendors as “free” consultants. They are usually very knowledgeable, having presented their product dozens of times, but are also careful not to overwhelm you with too much information at once. You can cross-check your information with them and be on your way to choosing the right EHR for your unique needs.

Better data ... better decisions ... better care