EMR & EHR software requirements are complex and a plenty. Electronic health records – or EHR – collect and standardize information needed for managing patients’ medical records. EHR software also allows you to share records, view trends and discover possible changes in patient history. The Medicare and Medicaid EHR incentive program is another reason to consider installing this type of software – giving you the opportunity to receive incentive payments for implementation.
The following requirements include what an EHR software participating in the program should have:
These software systems should have physician tools, making it easier for a physician to do their job with the patients. They can easily prescribe, track, and update medications for any patient. The system should provide tools for Computerized Physician Order Entry – or CPOE. These tools include:
- medication updates
- medication tracking, or eMAR
- CPOE templates
- short and long term care management
- order sets
You should also look for technical architectural features. These should be the basis for a strong infrastructure in the system you choose to use. One thing in particular to consider is whether the system will be installed into your private systems (called on-premise) or if it’ll be a software as a service (SaaS) or cloud-based EHR. These features in electronic health records include, but are not limited to, the following:
- audit trail
- storage and transmission encryptions
- the ability to lockout users
- backups and snapshots of the data
- data restoration in the event of a system wide crash
- high availability
You should also check to see if the system is CCHIT certified.
Other requirements, but could be part of the physical or support services of electronic health records, should also be checked. These include:
- phone and email abilities
- implementation services
- training for usage
- chat and instant message options
Communications should be checked as well. The way the system communicates with you could make the difference for other patients. These features include:
- online booking
- automatic reminders
- claim validation
- ERA- electronic remittance advice
- built-in and 3rd party patient portals
Other options or requirements of an EHR system could include:
- billing systems
- clinical exchange document data importing/exporting
- registries (cancer or otherwise)
- lab orders
- lab results
The final thing to check out is the vendor’s profile. Have you worked with them before? Will you work with them again based on the service you’re receiving? Contact others who have worked with your vendor if you have not worked with them before. Other things to check out include:
- financial stability
- customer base
- previous experience
- customer recommendations
Using these EHR selection templates can help you figure out which EHR system to use. If there is not a category mentioned that you think is important, don’t be afraid to evaluate a system based on that as well. Picking the best system for you is crucial to success.
EMR Software Requirements
Like the software mentioned above, software for electronic medical records have their own key points that should not be disregarded. There are two types of key requirements: physician work list requirements and charting capabilities within the software itself.
Every EMR software should have the ability to help the physician keep record of all medical records. These features could include:
- care plans
- outstanding lab or radiology results
- surgery histories
- patient data and health conditions
- vitals and measurements
When dealing with electronic medical records, the physician should be able to access everything with ease.
The charting capabilities found in each system also contribute to how easily a physician can access the records. These features could include:
- chart searches
- online check-ins
- prescription templates
- objective assessments
- plan note documentations
- electronic provider order entries
- follow up appointment reminders
Systems are often evaluated based largely on these two classifications of features. However, there are functional requirements that they are evaluated on as well. These can include, but are not limited to:
- assessments of dangerous drug interactions
- allergy assessments
- billing management
- lab result sharing
- lab order tracking
- electronic provider schedules
- insurance claim validation and insurance verification
- electronic remittance advice
- appointment management
There are also reporting functions that you should look at. Many will generate clinical quality reports, and financial analysis. There are also many systems that offer the ability to customize the reports to many degrees. Reporting capabilities could include:
- custom reports
- document management
- CPOE reports
- e-prescription reports
- Ad-hoc reports
There are also technical requirements that should be looked at. They should follow all law and regulation requirements under HIPAA, ONC-ATBC, and HITECH. Compliance to these will keep illegal activity to a low – especially if the technology decides to malfunction and you can’t catch it in time. In addition, you should look at how the system deploys. Will they offer host installation – IE the system is installed off site – or will it be installed directly into the system – on-premise installation?
Questions to Ask
There are a variety of important questions that you should ask when choosing a system. You will have to take into account a variety of issues before deciding which system to buy and which ones you could really do without. Some of the questions you could ask as you look at various systems include:
- What does your organization need?
- Do you required certified EHR technology?
- What kind of inefficiencies does the current system you are using have?
- How will getting an EMR system help your organization?
- Does the system at the top of your list introduce new limitations or will it solve the problems you currently have?
- Will the new system have the features you truly need?
- How well will the data you have in your existing system transfer to the new system?
- Who will implement the new system?
- Who will provide or be given training for the new system?
- Will upgrades and customer service be included as part of the purchase?
- How will the new system interface with the other systems in place?
- Can the EMR be easily integrated with the other services you use (billing systems, public health interfaces, etc.)?
- Where will the data be stored? Organization offices, a secure data center?
- If at a secure data center, what kind of security is available?
- Can the vendor make sure that the data will be accessible constantly?
- What happens in the event that security is breached or there’s a total system failure?
- Is there a warranty? If so, what does it cover and for how long?
About Meaningful Use
Part of implementation is adhering to “meaningful use”, hoping that meaningful use compliance results in:
- Better clinical results and patient care
- Improving population health results
- More transparent and efficient practices
- Empowered patients
- Robust growth in health data
Finding The Right Software
With so many vendors out there that sell this kind of system, narrowing down the list can be a daunting task. However, it is best to keep in mind that there are plenty of ways to help narrow the list down. When selecting a vendor, the first thing you should do is research. Look specifically at the reviews and surveys. This allows you to immediately eliminate any with poor reviews overall, or those that seem sketchy. A mismatch in priorities can happen if the vendor works primarily with companies that are a different size than yours – either smaller or larger. This will allow you to receive the best service for what you pay.
HealthIT.Gov also has some excellent resources on implementing EHR but don’t forgot about us when you go visit! 😉
Once the list is considerably shorter – down to the top 10 or 15 at the most – it’s easier to figure out which company to trust your data with. The first thing you should do after you have this shorter list of top contenders is to write up a request for a proposal. This will give the vendor the information about your company that they really need – such as top criteria for the EMR system and what your organization focuses on primarily.
When you have the responses from the vendors, invite your top choices to come to visit your organization. Ask them to demonstrate how their system will work and how it performs when in action. A rating form can be handed out to employees if you’d like to have their input before making a final decision. Make sure to do this before each demonstration if you’re seriously considering the companies and want to make sure the audience can follow and understand the system easily. This creates an easy way to get feedback on a particular vendor.
However, you shouldn’t overlook talking to references for each vendor. Other contacts that you know have worked with a certain vendor are also a good possibility for extra information and opinions before choosing a vendor. Make sure you are thorough with your questions since references are more likely to have positive reviews versus people you know who are more likely to offer you an honest opinion if the vendor, in all honesty, is not that great.
Some questions to consider include asking if the references would chose the vendor again, how satisfied they are with their decision to use a specific vendor, and how disruptive the installation of the new system was? If you’re looking for relatively low disruption, a vendor who takes three days to install is not viable. Also consider asking about the costs to maintain the system.
Both EMR and EHR systems are solutions that allow you to streamline the process of keeping health records and medical records up to date. However, the time and expense purchasing and implementing a new system sometimes exceeds what you are willing to pay at first glance, thoroughly looking into them is a must, which makes all information you gather valuable.
Looking for an EMR/EHR system and want to evaluate its features against your most important requirements? Use this free EMR/EHR requirements template to make a best-fit decision.