What to Look for in an Electronic Medical Records System

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Before choosing an electronic medical records (EMR) system, first determine your needs. “Make a list of what capabilities are important to you, and do your research,” says Melissa G. Young, MD, FACE, FACP, ECNU, endocrinologist at Mid Atlantic Diabetes and Endocrinology Associates LLC, and medical director of Novo Nordisk Diabetes Center, both in Freehold, NJ.

As part of your research, examine surveys. Which EMR systems are highly ranked by similar practices? “Some might be good for larger practices, while others are more suited for smaller practices,” Dr. Young says. “Some are geared toward certain diseases or specialties. When I was looking, I found that most focused on symptom-focused visits, such as those for pain, fever, or injury. Most didn’t have templates geared toward chronic illness management.”

For Dr. Young, it was important to find an EMR system that allowed her to create or edit templates on her own on the fly. “If guidelines change, new medications become available, or I determine that there is a question I ask often, I can add it in as I go,” she says.

The field of endocrinology, particularly in the management of diabetes, changes rapidly. “I need to be able to edit templates every few months,” Dr. Young says. “At a previous practice, if we wanted to change a template we had to ask the company to do it for us. That took days or even weeks.”

The system Dr Young chose includes a patient portal that allows patients to send their glucose readings between visits, which are downloaded from patient's insulin pumps and meters. “It is important to be able to save that data directly into patient charts,” she says, adding that she can tell patients if changes are necessary.

Researching vendors

An EMR system vendor needs to be available 24/7/365. “We rely on a lot of data to make clinical decisions,” Dr. Young says. “If that data is unavailable, I’m in trouble.”

Dr. Young advises asking other endocrinologists for vendor referrals and feedback. Ask them if a vendor responds promptly, if they can address issues remotely, and if they are accessible on holiday weekends. “Diseases don't take days off, so the EMR system can't either,” she says.

If your practice doesn’t have an in-house information technology (IT) person/department, ask if your EMR system vendor can act in that capacity, Dr. Young advises. “For a time, I had a different company handle the hardware and the network,” she says. “When things didn't work right, the question always was ‘is it the software, the hardware, or the network that’s causing the issue?’” It required calling both companies and having one blame the other one. Now her EMR system vendor has a sister IT company; staff overlaps and they communicate with each other, so it only requires one phone call and they figure out who's responsible for what.”

Expect a learning curve

It is much easier to start a practice with an EMR system. “There won’t be any transition from paper to software,” Dr. Young says. “You’ll create your workflow around the EMR system.”

If you have to transition to an EMR system, you’ll need to accept the fact that the workflow differs with the system. “I recommend only giving new patients an EMR; then slowly transition established patients a few at a time,” Dr. Young says. “Expect a learning curve, and that processes will take longer at the beginning. Make appointment times longer to give you time to chart. As you get more adept at it, you can shorten visit lengths again.”

There are definite benefits to electronic records-easy access from anywhere, allowing multiple users access to the same chart simultaneously, legibility, and flowsheets. “Although there are days I miss the old-fashioned scribbling of two lines,” Dr. Young concludes.

Click here for an at-a-glance look at 5 top EMRs for endocrinology practices.