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Quick summary: Sandra Weitz, MD, shares that, although, choosing an EMR for your practice can be challenging she'll give you tips to help narrow down the overwhelming number of choices.

Documentation is a frustrating, burdensome necessity of practicing medicine. Regardless of which Electronic Medical Record (EMR) you are currently using, I promise that someone put a tremendous amount of time choosing it. And, as a private practice owner, the responsibility of picking the best EMR falls to you!

There are several points to consider when choosing an EMR. Let’s start with the fact that none of them are perfect. No matter how much effort you expend doing your due diligence, you’ll ultimately find things you don’t like about the EMR you choose. Second, as with most things, you get what you pay for.

 

Determine What You Want the EMR To Do

Before starting to compare the functionality of one EMR to another, you need to understand your practice and its workflow. Once you accept that there is no perfect EMR, make a list of your must-have features. The goal here is to make your life easier. Having a fancy feature that you’ll infrequently use isn’t beneficial if it means that your everyday workflow involves more clicks or navigating more screens.

 

Easy to Use

Your EMR is more than digitized form of your note. Think about all the other documents like lab tests, imaging studies and notes from other providers that you review daily. How do they get into your EMR?

Who sets up the filing system for information within the EMR? Does the software company do it or your office? If a document arrives as a piece of paper, who scans it into the EMR? Regardless of whether it was a scanned document or one that came electronically, it still needs to be filed in the appropriate location. How easy is it to file within your EMR software? how exactly that was done?

 

Integration

Some EMRs have more robust e-prescribing modules than others. How many steps does it take to send a prescription? Can you do it from within the visit? From within the software or do you need another product. The answers to these questions will help you determine the degree of hassle.

Another consideration is whether the software is an all-in-one with your practice management software. Most EMR software have a scheduling module, patient portal and message center. But not all of them are great at coding and helping you drop the charge. For example, there are some EMR that suggest the appropriate code and others that can even suggest ways to improve your coding. Others rely on you to code. Then if your EMR is not linked to your billing, how easy is it for that charge to get dropped?

Key Point: Understanding your practice’s workflow will help you determine which EMR features are a must-have.

 

Some EMRs have more robust e-prescribing modules than others. How many steps does it take to send a prescription? Can you do it from within the visit? #privatepractice Click To Tweet

 

 

Enterprise or Cloud-Based EMR

Enterprise software requires you to have a server because that’s where the software is housed. If you choose an enterprise based EMR there are several things, you’ll need to consider. Do you have space for the computer hardware? How much will the server and server maintenance cost? Who will be responsible for managing the server? Will enterprise-based software increase your overall IT costs? How will the data be backed up? What happens when the server goes down?  Recognize that calling the EMR company is not going to help you since this is a hardware issue and not their software problem. Enterprise-based EMRs requires more infrastructure.

As the name describes, cloud-based software sits on servers owned and maintained by the EMR company. Cloud-based EMRs can typically be accessed from any device. And most cloud based EMR companies have robust data backup and server redundancy so if you have an internet.

You’ll want to consider how people will connect to the internet. Will it be wired or wireless? What is the workflow like in your office? Is there a desktop for each staff member or a thin client (monitor) that connects to a server? Or will each employee have a laptop or tablet that they carry around?

Bandwidth can create a choke point for cloud based EMRs. If patients and staff are all using the internet at the same time, your upload and download speeds may be compromised. Everyone complains about the number of keystrokes and clicks required to complete a chart. Now think about how frustrating it is to wait for a page load for you to continue completing your charting.

 

Bandwidth can create a choke point for cloud based EMRs. If patients and staff are all using the internet at the same time, your upload and download speeds may be compromised. Click To Tweet

 

 

Hire an IT consultant

Hiring an IT specialist to help you determine your IT needs is an invaluable investment. The small amount of money that the IT consultant costs pales comparison to the amount you’re going to spend on an EMR and any impact that it costs you by not optimizing your productivity.  There are cost differences between enterprise and cloud based EMR software, but it may not be as great as you think. I recommend creating a spreadsheet to compare the costs.

These are big picture considerations that will have the biggest impact on your decision-making and budget. and your consideration of specific vendors and their products. Think through these logistical issues before evaluating specific vendors. It will help you narrow down your choices and make the EMR software selection process seem less overwhelming.

 

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Sandra Weitz MD

Physician Entrepreneur, The Practice Building MD

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