Electronic Health Reporter

There’s a special place in my heart for electronic health records. Having worked with one of the largest vendors (at the time; the company has since shed about 20,000 of its physician users) I understand their capabilities and how they can benefit a practice beyond just how they are marketed. EHRs are one of the reasons I started this blog, in fact. If I could spend more time on them and keep people interested in this site, I would, but not everyone feels that way I do about them so I’m forced to broaden my horizons and cover a variety of other topics.

Alas, I also feel we’re entering their final days glory days. I believe 2013 will be the year of transition in which we as a market decide that EHRs are foundational and that other, new technologies are emerging that will either make EHRs better or render them essentially useless. Until then, though, I’ll allow myself to continue to focus on them from time to time and hopefully you’ll find the information relevant, which brings me to today.

Found an interesting piece in Executive Insight magazine by Meditab’s VP of Marketing, Kirk Treasure. Though Treasure makes the claim (like most EHR vendors continue to do) that EHRs are increasingly important to the continued streamlining and delivery of patient services, but he says, because of a recent KLAS report, that practices and health systems are becoming dissatisfied with their EHR vendors and their systems.

This really comes as no surprise and has been expected. Some of this has to do with vendors trying to get by on the status quo while some of this has to do with crippling meaningful use regulation. Some of it has to do with promises not kept or promising too much (which is usually the case), but again, there’s nothing surprising here. It’s where we are in the market.

According to Treasure, there are two reasons for this wave of provider dissatisfaction.

One: “Many physicians are basing their decision primarily on cost factors, not realizing that cheaper is not necessarily better.”

Two: “Many practices are not 100 percent comfortable with their own internal processes, and as a result, purchase an EHR system that does not satisfy their needs.”

Treasure warns those in the market for an EHR to take their time to evaluate their needs and future goals of the practice then look at what they can realistically afford to invest in a system. “It’s important to weigh out whether or not a perceived expensive initial cost will save you money in the long-run,” he said.

“Next, analyze your workflow to see which processes you would like to maintain and what areas you would like to improve,” he added. “This will help in cultivating efficiency and organization throughout the practice, while ensuring that your EHR system supports your goals.”

Treasure continues his golden advice. Vendors need to look for systems that meet the specific requirements of their practice and to understand that there is no “one-size-fits-all solution,” even within the same medical specialty. Once a list of vendors has been narrowed down, check references (this is an absolute must) and try to speak with several clients that have been using the system for at least a year. According to Treasure, “They can tell you about any obstacles encountered during the implementation, their support experience and the benefits from making the switch.”

Here are some other suggestions to purchase the right EHR system for your practice and avoid a costly mistake, from Treasure:

• Understand the total cost of ownership of each vendor’s pricing structure. For example, some cloud-based vendors provide EHR services on a subscription basis. Paying $400-$600 a month for a five-year contract period would result in a $30,000 commitment plus the initial investment for implementation and training. Alternatively, the total cost of ownership for a server-based office system with a $10,000 upfront cost and a $200 monthly maintenance would only be $22,000.

• Look for hidden costs in the contract, such as additional fees for in-person training, document management services, EDI setup, or annual maintenance fees in addition to the monthly support costs. Also, watch for provisions that allow the vendor to increase fees during the course of the contract.

• Ask the vendor if the system will accommodate any potential changes in your practice model. This could include, for example, joining an accountable care organization (ACO), adding telemedicine services or expanding upon the practice concentration in the future (i.e. bariatric, weight management, etc.).

• Consider the EHR system from the point of view of the patient, as well as the physician and office staff. For example, is the EHR system easy to use in the examination room? Does it provide reports on waiting times or other service delivery issues?

• Be sure that you “own” the data under the terms of the contract. Some vendors charge a fee for exporting the data to a new system before the contract expiration date.

• See if there are provisions that would allow you to get out of a contract after six months or a year. This is essential if the system ends up not working for you.

• Finally, be sure you are comfortable with the vendor. In many cases, a smaller or mid-size company can provide a higher level of personal service. That’s an important consideration in helping physicians and office staff take advantage of the many potential benefits of deploying an EHR system customized to the needs of the practice.