Did you know 99 percent of hospitals utilize electronic health record systems? As these systems mature, the EHR software market grows and the consolidation of health systems continues. Now it’s becoming obvious there is a strong need to find scalable, sustainable and suitable health information technology for healthcare practices of all sizes and scopes. To help your practice with this process, we’ve put together a comprehensive EHR vendor comparison chart to get you started on the path to the perfect system.
EHR technology forms the foundation of a medical practice’s operations. Patient care is driven by the ability to understand and add to the patient’s experience with both acute care and long-term care for disease and injury. From check-in through billing and revenue capture, EHR platforms help organizations run smoothly and generate value from the business they conduct.
The convergence of the Electronic Medical Records (EMR) and Electronic Health Records (EHR) markets has created a variety of blended products that function as both systems. EMRs and EHRs are used as the platform for clinical, financial and operational activities related to both hospital and ambulatory locations. They are designed to follow the patient through the entire continuum of care. Whether a solo provider or a large integrated hospital system, EHR technology has matured to fit the needs of any clinical encounter.
EHR Software Comparison: Considerations for Selection
There are many options when choosing EHR applications. To help you evaluate the best system to meet your needs, listed below are the key differences among various software you could select.
Documentation Habits and Clinical Workflow
These functions are considered some of the most important aspects of patient care and, therefore, are key to selecting the appropriate EHR application. Make sure the EHR you select allows both physicians and administrative staff to incorporate their work and efforts into the clinical record.
Evaluate current best-practice workflows and documentation styles for a clinical environment. Be aware that not all workflows and documentation styles will be supported by every EHR. Even though it is possible to configure and customize a system to fit a practice’s needs, assurances of functionality aren’t enough when creating an environment for success with an EHR application.
Medical billing software that are included in or can be integrated with EHR applications are crucially important to a practice’s success. Without the ability to accurately code and bill for services rendered, operations will grind to a halt and profits will not be realized. You should select an EHR with an internal module to bill patients and insurance, or ensure that the EHR can connect seamlessly to your existing revenue cycle management (RCM) service.
Population Health Management
This is a key aspect of EHR software which should also be considered when evaluating new platforms. If the clinic is currently involved in or has any plans to begin using patient data to improve care for specific populations of patients, then an EHR that includes features that best allow for these activities should be considered.
This is especially important if the organization is part of any risk-bearing contracts or partnerships with payers, including CMS (Medicare / Medicaid). It is also key if the organization takes part in an Accountable Care Organization or any other diverse partnership related to quality and utilization. It is wise to consider how an EHR would support the needs as they are today and how they may advance in the future.
EHR deployment can be accomplished in two distinct ways. They can be client-hosted on their premises or accessed through a web-based connection to the cloud. Both function similarly, but come with unique pros and cons. For a comprehensive dive into this issue, check out our cloud-based vs on-premise EHR comparison.
For a brief overview, on-premise is typically more secure, more customizable and is accessible without an internet connection. It is also more expensive, requires more in-house support and is a less popular offering from vendors.
Cloud-based is convenient to access, cheaper and allows users to connect from a range of devices, making it very mobile. It is also slightly less secure, less customizable (unless you’re willing to pay for it) and can be prone to going down for maintenance without warning depending on your vendor or internet provider.
Do research and decide which deployment option is right for you — as well as how different systems are reviewed from both deployment options — before you buy.
This may not be at the top of your wish list when determining which EHR system to select. However, given how important hardware is to clinical operations and efficient workflow, it’s worth considering. Keep the following questions in mind to ensure you select an EHR that is compatible with the way you currently operate, as well as the ways you might want to work in the future.
- Do your providers want to use a tablet?
- Do your providers want to continue to use a narrative built by dictation/transcription?
- Do you have providers that want to use speech recognition software?
- Do you have previously-built templates that you’d like to leverage for future use?
- Does your clinic have any other specific documentation needs that need to be considered?
Having a prepared list of documented questions and requirements is important for successful vetting when comparing EHR systems. Without appropriate methods for capturing the patient story and the clinical moment, a new EHR system may cause more issues that initially anticipated.
This feature refers to the ability to share clinical content with outside agencies, organizations and clinics. Clinical, financial and demographic data can be shared with others through a variety of technological functions. From intensive interfacing to the use of secure email, an EHR that includes the ability to share information is key to creating a comprehensive longitudinal patient record. A longitudinal record — a record that compiles and tracks a patient’s entire history rather than relying on single encounters — can decrease costs, increase patient compliance and limit potential for error.
Though certified applications will have some aspects of interoperability built into their systems, it is important to know what methods are currently in use and available to other practices as well as your own. This could include connecting to a local or regional Health Information Exchange (HIE), joining a clinically integrated network (CIN), or building interfaces to the key locations with which a majority or plurality of patients are shared.
EHR records are created so they can be leveraged at other points of care, regardless of the EHR in use. Transitioning from primary care to specialist, inpatient to outpatient or from one health system to another are all important aspects to consider when evaluating new EHR technology.
The chart notes resulting from this communication are shared with consulting and complementary providers. These are the calling-card of the practice, both from the perspective of the referring physician as well as the patient. If the notes shared during a transition aren’t adequate, thorough or provided in a manner that makes the data elements easy to incorporate into another application, the patient and the provider will see this as a negative reflection on the practice.
Certified EHR Technology
Certification is relied upon by a range of EHR incentive programs from individual payers to governmental organizations. Certification is a distinction given to EHR vendors that have products that meet a variety of criteria related to functionality, security and interoperability. Depending on the organization’s goals, it may be beneficial to limit potential vendors to only those that have received certification from a trusted organization.
Certification does not, in and of itself, create a successful partnership and should be looked upon as a feature, not a sole reason to acquire a specific product. That being said, using a certified product will, at a minimum, afford a clinic or hospital the opportunity to participate in a variety of programs. If they are successfully implemented and adhered to, these programs can prove to be lucrative and rewarding.
EHR is expensive, don’t get me wrong. But to many organizations, an EHR is built into the traditional costs of doing business and without one, the basic operations would not be possible. For other organizations, building a model to discern the return on investment they would receive from moving to an EHR application can offer insight into the benefits of adopting an EHR.
At this point in the maturation of EHR technology, the best way to justify the increase in costs is to determine how much more efficient, well-connected, well positioned and competitive clinical operations can be if a new EHR application was implemented. Very few medical providers — one percent of hospitals and 13 percent of office-based physicians — don’t utilize EHR, so practices that don’t should look seriously into what those numbers suggest about the cost of not adopting EHR.
Migration of Data
If you’re replacing an EHR and your practice has data to migrate to a new clinical system, it is important to take this section very seriously to ensure all clinical data is appropriately imported to the new application. Without including the historical data into the new application, a lot of problems, errors and additional costs can be accrued. Many EHR organizations will work with existing EHR to export data before the new application goes live.
There are a variety of potential formats in which to transfer existing data into a new EHR. Full records can be sent using HL7 CDA format, SQL queries and/or proprietary import functions. If a prospective vendor is unwilling (or unable) to incorporate your historical clinical data into their system as part of your EHR implementation, they may not be the best fit. Most will offer this service either as part of the startup cost or for an additional fee.
It is of the utmost importance to prioritize the re-creation of every patient in your new system without the loss of any key historical and billing data. Current and future reporting requirements highly value the continuity of data, and it contributes to value-based patient care.
Engagement of Staff
Beyond the structural and technical objectives of an EHR evaluation, it is imperative to make sure that clinical resources and staff are engaged and willing to make the change. A lot of processes and workflows within an organization will change due to a new application. Some of these changes will be for the better, but there will inevitably be some changes that are met with resistance.
Build a team of advisors from all areas of a clinical environment to assist with the evaluation process. Let each resource objectively evaluate the technology and functionality to ensure it matches the needs of the representative group of employees.
Most EHR vendors offer training resources to help smooth the adoption process, so make sure to ask about them. Some will come at an additional cost, so we recommend reading reviews of implementation processes with each vendor to see if additional paid training courses are worth the cost.
EHR vs EMR
Do you need an EHR or an EMR? While the two have similar functions, EMR software’s core function is to track information about a patient’s care, like test results and prescription medications. You can use EMR systems to issue repeat prescriptions, schedule appointments and bill patients. EHR software does the same thing as an EMR, but also provides communication features that allow healthcare providers from different organizations to collaborate on patient care. If you’re not sure which your practice needs, check out our EHR/EMR requirements checklist.
EHR Adoption and Selection
When doing EHR comparisons, it is important to have representatives from any vetted EHR vendor demonstrate the functionality and usability of their application on-site at your clinical location. Let clinical staff use the application in a simulated environment to observe their interaction with the application within the defined workflow of normal clinic operations. This process should be repeated for ancillary staff (billing, coding, etc.) if they will also utilize the application. Though an application can be customized and/or configured for specific use, it is crucial to evaluate existing functionality to identify potential bottlenecks and frustrations in patient care areas.
Site visits to similar organizations is an important step to take in order to glean objective information from existing clients using the same application. Conduct both a walkthrough of operations as well as a candid conversation with key leadership to learn about functionality and workflow, as well as any service/outage complaints or issues with upgrades and custom functionality. The unbiased feedback that can be provided by a similar clinic is important as it will identify expected issues that can be planned/accounted for.
When a final EHR partner has been identified, the contracting process becomes a formidable step to ensure a sound and successful investment. It is important to leverage experts in the field of procurement and negotiation to assist with building the price for services rendered and software delivered. A well-negotiated EHR contract is important to maintaining financial sustainability and profit as well as to ensure all systems are running without issue or inappropriate downtime.
When a new EHR is implemented, plan for a significant reduction in productivity. It is important to spend the time and resources up front to ensure that all resources are adequately trained and familiar with the system before your volume of patient visits and encounters can return to normal levels. Document all processes and workflows to assist with the onboarding of new employees in the future as it will be helpful to have a turn-key approach to bringing aboard new resources.
The software selection process is different for every organization, but the beginning steps are very similar no matter your size or specialty. Luckily, there are plenty of resources out there to make the process to compare EHR systems smooth and painless. Don’t forget to download our EHR requirements gathering template and EHR comparison chart to get off to the right start.
Did you find this guide helpful? What other questions can we answer? Let us know in the comments!