By Nathan Stott, Practice Director
Selecting an electronic health records (EHR) system can be a difficult undertaking for any practice. In our last post, we discussed some of the important details regarding EHR use under the new MACRA ruling. With the largest percentage (25%) of the MIPS composite score for 2017 being reliant upon the Advancing Care Information category, the replacement for Meaningful Use, it is imperative that practices are using the right EHR system to receive positive Medicare payment adjustments. In addition, selecting the right EHR system can improve patient outcomes and save time and money for your practice, but how do you choose the right one?
Let’s take a look at a few key factors to consider when selecting a new EHR system:
The first and most important step in selecting an EHR system is the planning phase. Before sitting down with an EHR vendor or consulting firm you should ensure you:
- have researched the EHR market, including competing vendors, products, and services, together with price and service terms;
- have assessed your organization’s need for and readiness to implement or to transition to a new EHR;
- have a vision and plan for how the EHR will support your needs, which should be informed by input from clinical, administrative, IT, and other relevant representation throughout your organization;
- have prepared a priority checklist of features and functionality you want in your EHR; understand the importance of health IT certification and the regulatory requirements impacting EHR acquisition and use;
- and understand the security and privacy requirements that apply under both federal and state laws and regulations, and the best practices that you desire above and beyond legal minimums.
Questions to Consider
Now that you’ve assessed your organization’s needs and done a little research into the available EHR options on the market, here are a few factors to consider when choosing a system.
- Costs- While providing quality patient care is your number one priority, your practice is still a business. The prices of EHR systems vary greatly based on selected features, vendor certifications, and the size of your practice. When requesting an estimate, find out what the initial licensing or activation costs are and how much each additional component (such as a practice management system) will add to the price.
- Ease of Use- This factor is, perhaps, one of the most important to consider. If a system is not intuitive or doesn’t fit your practice’s workflow, it can greatly affect the number of patients you are able to care for. Take advantage of free trials or live demos; you will be using this system every single day, so make sure it is one that works for you.
- Provider-Hosted vs. Cloud-based EHR- Provider-hosted EHR systems require the organization to operate and maintain their own servers. Cloud-based EHR systems mean there are no servers or hardware to maintain in your office besides your own computers. Cloud-based systems allow you to cut costs by outsourcing IT maintenance and technical support
- Interoperability- MACRA requires that your EHR system be able to transfer patient information to other information systems. E-prescribing and ordering lab tests and results are useful features that will also help achieve your highest possible composite score.
- Implementation, Training and Customer Service- Implementation times can vary drastically, so it’s important to know your vendor’s plan when it comes to getting your system setup and running. Additionally, you will want to look for a vendor that provides training to all staff that will use the new system. Also, you’ll want your vendor to provide timely customer service throughout the time you use the system.
Negotiating Contract Terms & Understanding the Fine Print
You’ve done all your research and now you are ready to sign a contract with the EHR vendor of your choice. A carefully negotiated contract can minimize the potential for future problems and create a more beneficial relationship between your practice and the vendor. Here are a few tips to help untangle the contract negotiation process:
- Standard Form vs. Negotiable Contracts- It is best to ask an EHR vendor for information regarding its contracting practices early in your EHR search. Some vendors use a standard contract that leaves little to no room for negotiation; others will work with your organization to draft a contract that is in both parties’ best interests. You should also assess your negotiating leverage and the extent to which you are prepared to compromise in some areas to achieve a more favorable outcome in others.
- Shared Responsibility for Safety and Security- It is vital that both your organization and the EHR vendor share the responsibility for safety and security performance.
- Express Warranties- It is important to be sure that your contract includes an express warranty for all services and performance expectations provided by the system. Warranties create legally enforceable rights that you can use to obtain the necessary performance that you desire or to pursue your vendor for damages.
- Data Rights- Many standard form EHR contracts grant vendors very broad rights to use and commercialize data captured in or created by an EHR. This creates a lot of room for data breaches and unnecessary sharing of patient information. To mitigate these risks only grant your vendor rights to EHR data that is necessary for it to perform the required services
- Patient Access to Electronic Health Information- HIPAA compliance requires that healthcare providers make health information available to patients electronically. It is important that your EHR contract address how the vendor will support and assist you in fulfilling these responsibilities.
Selecting and negotiating the acquisition of an electronic health record system (EHR) is a challenging but important undertaking for any healthcare organization. Navigating the vast landscape of available EHR vendors is no simple task. Partnering with your trusted IT company for EHR selection, deployment and support can take the difficulty out of the process. Whether choosing to adopt an EHR for the first time, or deciding to migrate to a different solution, a committed IT company will guide you through the transition successfully resulting in real workflow efficiency, higher net patient revenue, and provide immediate support and issue resolution.