It May Be Time to Switch Your EHR Thinking

Written by on December 31, 2013 in Research & Technology - No comments

This year, 2013, has been dubbed “The Year of the EHR Switch” and with good reason!

Many physicians and healthcare facilities jumped on the bandwagon early to comply with federal mandates to digitalize records- even before meaningful use criteria was determined. It seemed that over night, there were more than 500 vendors. Most did not interface with each other.

Now, we have not only criteria for this but Stage 2 Meaningful Use requirements as well. Many of the earlier EMR systems were not built with the criteria in mind and have not upgraded accordingly.

So, ask yourself, “Is my EHR system meeting my needs? This is a crucial question that you need to answer and one that is being eyed across the country. For those that are first scrambling to get a system, do you know what your needs are?

In view of increasing liability from “cut and paste” techniques on templates that have gotten many doctors in hot water, there are several issues to consider regarding a digital system.

21 Questions to Ask When Considering an EHR

While it is natural to see what other medical practices are using, there are key questions that should be asked prior to picking out a vendor for the EHR that is most appropriate for you. It’s time to bring out the game of 21 questions just like the one you played as a youngster. (Upgraded, of course!)

1. Is it compatible with both IBM PC and MAC computers?

2. Will the new system interface with the computer system of your affiliated hospital?

3. Does it meet the criteria for Meaningful Use Stage I and II?

4. Is there a separate flow sheet for medications, laboratory test results and radiological test findings?

5. If your practice focuses on a specific area of medicine, is this program geared to my specialty? Templates, terminology and coding for a specific specialty will decrease headaches and save time.

6. Are there templates specific to your specialty that will document repetitive acts and highlight abnormalities?

7. Can you emphasize abnormal findings without entering data for segments of the template that were not performed on a given day?

8. Are there printed notifications to you and your patients when medications are recalled or when new warnings are issued regarding drugs that your patients are on?

9. Is there a patient portal built into the system with easy access?

10. Is the system certified?

11. How is the training for implementation of the system?

Is it?

  • Video training
  • Onsite training
  • Training at your office?

12. What is the support system provided by the vendor?

  • Is it a 24/7 manned support to answer any technical questions (when the problem arises and before frustration and tempers flare) or is the support only available from 9-5 on Monday through Friday?
  • Is it a live answer or must you email the problem to be answered later?

13. Will the vendor upgrade the system as federal requirements are amended? Is there a fee for this?

14 .Is there a fee for each user to the system or does the cost encompass the entire practice?

15. Can this system be used or interfaced in multiple locations?

16. Can this system be used on multiple devices?

  • Desktop computers
  • Tablets
  • Smart phones

17. Can this system easily integrate information from a previous system? How easy is it to export your records to take them to a new system? Remember, the patient data is yours.

18. Does this system function with voice-recognition programs as well as physically entering data?

19. Will the vendor put you in touch with a local practice similar to yours so that you can bring your team for a visit and discuss how happy they are with their current system?

Of course every salesperson will tell you their electronic medical record software is easy to use. You need to decide for yourself what “easy to use” means and how easy it was for current clients to implement.

20. Does this vendor support both a cloud system and onsite system?

21. What is the storage or backup for files? Is it done automatically and easily accessible from any location?

 Is it Time For the Change?

Let’s face it. We all hate change. We hate having to go through this daunting task of redoing files and relearning how to implement a new system…and we hate incurring a new cost!

The thing is, if your vendor does not keep you prepared and does not protect you from pitfalls that an old system may expose you to, it may be more costly and more frightening not to switch!

However, you can protect yourself a bit for a vendor change in the future.

 Construct a Back Door

After you have had a “legal eagle” oversee your vendor contract, do not sign until there is an “opt out” or cancellation clause inserted.

If the system that you have elected to implement, no longer functions up to your expectations and you see a better system that works for you or is more affordable, you don’t want to be locked into a system that you loathe. Having no means of opting out translates to having to throw thousands of dollars away to pay a vendor for a commitment while changing. If there is an early termination fee, know about this ahead of time. There should be no unplanned expenditures.

Good luck with your new system. Despite changes coming down the road, hopefully you can grow with this vendor and system for years to come.

By Barbara Hales, M.D.

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