Five Steps for Choosing the Best EMR

I opened Sunrise Urology in Gilbert, Ariz, with the goal to provide patients with complete urologic services in a private, convenient location. Wanting the most technologically-advanced practice possible and having experienced the everyday clutter, disorganization, and inefficiency with a paper-based documentation system, I knew that an electronic medical record (EMR) system was the way to go to help ensure longterm success for my practice. Where to start? Remember that an EMR is a big investment in not only money, but also time. You cannot delegate its selection to someone else—all of the stakeholders have to agree on the product. The following are five guidelines I feel helped me during the process:

1. Perform due diligence. One of the most important steps in the process is to determine what you and your staff need, want, and expect from an EMR. Also, keep in mind that an EMR won’t help you fix existing inefficient workflow problems, so be sure to resolve those issues first. Additionally, engage an objective consultant who has no financial ties with any EMR vendor to help you ask informed questions and negotiate contract terms. Once you narrow down vendors, ask them for a demonstration. When checking references, talk to the support staff, and not just the office manager or a physician. Get information from other product users on specialty society “listservs” and bulletin boards.

2. Acquire a CCHIT-certified product. A Certification Commission for Healthcare Information Technology (CCHIT)-certified product ensures that a company’s product meets minimum “standards” for interoperability, functionality, and security. This will not only narrow down your search, but will also help to find an EMR partner who is in it for the long haul.

3. Choose a product that does more than what you currently want it to do. Though you might start small, you want the opportunity for your practice to grow with your product. Do you want a product that has the option of online patient portals, electronic prescriptions, bidirectional fax capabilities, prescription dispensing capabilities, and bidirectional lab interfaces? Will it take input from voice recognition, typing, tablet/writing, and traditional transcriptions? Think in the long term. Though it may be overwhelming at first, you will want a product that has the capability to meet your expectations as you become more comfortable with your EMR. Don’t get “trapped” in a limited-function EMR that you cannot upgrade and expand.

4. Acquire a fault-tolerant, fullyintegrated product. Be aware of the challenges of “interfaces” between practice management software and EMR software from two different vendors, as there is the possibility of fingerpointing if something doesn’t go as planned. You also want to find a pro product that anticipates hardware failure, as it can and will happen. Does your EMR vendor offer immediate disaster recovery/ backup? Keep in mind that you cannot even cancel your patient’s appointments if your practice management EMR system crashes. Make sure to take those extra steps to ensure that your data is backed up redundantly, onsite and off-site. Reputable vendors will have this data security in place already.

5. Look for responsive support in a stable company with a proven track record. Ensure that you have the necessary implementation, training, and technical support from a vendor that will be there for you when you need it. Your vendor’s support team will be an important partner to your practice—choose one you want to work with. John C. Lin, MD, is a principal at Sunrise Urology. The integrated practice management and EMR system he works with is Allscripts’ HealthMatics Office.