Choosing the Right EHR System: A Buyer’s Guide

How to choose the right EHR system

Take the below steps to research EHR systems and decide which platform best fits your practice.

1. Broadly consider your needs and key distinctions.

Maybe you’re seeking an EHR system that’s full of dermatology codes to streamline your specialty billing. Those kinds of needs are important to consider during your search for the right EHR platform. Some systems will offer solutions tailored to dermatologists (and plenty of other specialties), whereas others are more generalized. Chances are you’ll benefit more from specialized than generalized solutions.

Additionally, one EHR system may suit practices of one size better than another vendor’s system. That makes size a key distinction to keep in mind as you start your research. Evaluate this distinction alongside your budget and internal workflows as you look at potential vendors.

EHRs don’t just impact physicians, but every facet of the practice. This is especially true when a practice management system or revenue cycle management integrates with the system. Everyone in the practice should be familiar with the implementation goals and long-term strategy.

2. Determine the exact features you want.

Are you most in need of patient charting technology, or is a patient scheduling tool just as important? List all the features you’d like your EHR system to include, then rank them by importance. As you compare potential platforms, look to see which platforms provide the highest-quality tools in the areas you’ve prioritized.

3. Look at key information sources about your potential EHR providers.

Your EHR provider’s website may include a pricing page detailing several pricing packages and the features they include. These pages are wellsprings of important information about what you’ll get when you choose that vendor and at what prices. 

Online customer reviews on Trustpilot and the Better Business Bureau’s website also give you valuable information. So do the real-life experiences of other medical professionals you know who have used the platforms you’re considering. Take note of everything you learn as you review all this customer feedback, and consider it while moving forward. 

4. Review integrations, interoperability and compliance features.

Confirm that any EHR systems you’re considering fully connect to your other key software platforms to ensure universal data across your practice. Just as importantly, verify that any potential vendors include features for sharing patient data with third parties in HIPAA-compliant ways. These features fall under the umbrella of interoperability, and they streamline the involvement of specialists, pharmacies and other entities in your patients’ care.

Speaking of HIPAA: When comparing potential vendors, look for information that clearly explains how the platform commits to complying with HIPAA and other regulations. Features such as audit trails should be available to ensure data safety and privacy.

5. Pursue free trials and product demos.

Any time you’re looking to implement new software, a free trial is the single best asset for making an informed decision. You’ll typically get seven to 30 days to use the platform, giving you a no-commitment opportunity to see whether it works well for your practice. 

When free trials aren’t available, guided product demos are your next best bet. A company representative will walk you through the platform’s key features and show you them in action. This is a step up from simply seeing the features listed in a comparison table.

6. Make your decision.

At this point, you have all the information you need. Compare each platform’s user commentary, prices and features to sort your potential options from best to worst. Sign up for the best platform, and start the implementation process.

Factors to consider when choosing an EHR system

While you’re required by the HIPAA to ensure patient data in any EHR system is secure, there are many other considerations when choosing an EHR system. Here are a few:

1. Cost 

The price of an EHR system depends on the features you choose, the vendor you select and how many providers are in your practice. When requesting an estimate, find out the initial licensing or activation costs and how much each additional component (such as a practice management system) will add to the price. Typically, for smaller practices, the price is based on a monthly subscription fee multiplied by the number of providers using the system. 

For our recommendations, subscription costs range from $150 to $1,100 per provider per month after activation or licensing costs. Those fees may cost a few hundred to a few thousand dollars. Pricing fluctuates based on the specifics of each practice and will be determined in consultation with the vendor. 

2. Ease of use 

If a system isn’t intuitive, it can grind your workflow to a halt as your staff struggles to accomplish routine tasks. Remember, you will use this system every day, so you don’t want one that will take you away from your patients or add hours to your daily workload. Ease of use doesn’t end at the provider; office staff and billing managers also need to understand how to use the system.

3. Cloud-based hosting 

Most major EHR vendors offer a cloud-hosted option, meaning there are no servers or hardware to maintain in your office besides your own computers. Cloud-hosted systems provide a relatively cheap way to outsource the costs of IT maintenance and technical support to the vendor. We recommend a cloud-based option unless you have a specific reason to host servers on-site.

4. Implementation and training 

The implementation of an EHR system can take anywhere from a few weeks to a couple of months, so it’s important to know your vendor’s plan for getting your system up and running. In addition, some vendors offer physician and staff training to make sure everyone in your practice is up to speed with the new software. Occasionally, a vendor will offer one-on-one support at no extra cost for a limited time after the system is implemented. 

5. Integration

Some useful features of EHRs include e-prescribing and electronically ordering laboratory tests and results. However, not every lab, hospital and pharmacy will be configured to interface properly with every EHR system. To ensure interoperability, which is a primary focus of the government’s Meaningful Use Stage 3 guidelines, talk to vendors about which interfaces they employ and whether or not those are compatible with the surrounding facilities in your area. Many vendors are willing to build out additional integrations upon request, so find out if that is possible and if it would be included in your subscription costs.

6. Customer service 

Acclimating to a new EHR system is no small task, so make sure the vendor will be there to support you along the way. If its customer service is difficult to reach or not particularly eager to answer questions before you buy, the service might not be helpful when you’re trying to figure out your new system later. A good working relationship with the vendor you choose is key to a successful transition to a new EHR system. 

7. ONC EHR certification

Regulations surrounding medical software continue to evolve, but a system should meet baseline requirements set out by the Centers for Medicare & Medicaid Services (CMS). These certifications are also relevant for Medicare and Medicaid reimbursement payments and whether a practice is eligible for any incentive payments or subject to any penalties based on their use of medical software.

Types of EHR systems

There are four main types of EHR systems.

1. Physician-hosted: If your EHR system is physician-hosted, then all your medical data is stored on servers within your facility. In this case, you’re responsible for buying all data storage hardware. You’ll also need to implement information security measures that keep your practice HIPAA-compliant. Although on-site hosting can make your EHR system faster, implementing it can be expensive. It’s best left to hospital-sized practices.
2. Remotely hosted or dedicated remote: The servers for a remotely hosted EHR system are based outside of your practice. This arrangement relieves your practices of the issue of data storage, but you do remain responsible for data security. In other words, it only partially relieves your IT burden. That said, remotely hosted options are beneficial for smaller practices unable to afford physician-hosted solutions.
3. Subsidized remote: When your practice uses a subsidized remote EHR, it pays another medical practice for access to its EHR. For example, if a nearby hospital provides EHR access to your practice, then you’re working with a subsidized remote system. In this arrangement, your EHR system management costs are minimal, but data ownership issues can arise.
4. Cloud-based: Perhaps the most popular type of EHR system, cloud-based EHRs don’t require on-site servers. Instead, your cloud-based EHR vendor will store all your EHR data in the cloud. This cloud access results in enhanced data security, in part because your practice’s data is available only through the EHR vendor’s HIPAA-compliant platforms. It also relieves your practice of virtually all healthcare IT concerns.

Max Freedman contributed to this article.