As of 2017, more than 95% of all hospitals in the United States possessed a certified electronic health record system. What is not as clear is how many of those hospitals are using the right EHR software for their needs and goals. The benefits of EHR technology have the potential to be significant, but many healthcare organizations experience more hassle than help from electronic health records. In these cases, hospitals and practices need to know how to select an EHR that works best for their size, scope, and strategic goals.
In this blog post, we’ll explore the EHR selection process in depth—including how to identify your selection criteria, evaluate your vendor thoughtfully, and avoid common mistakes.
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Why You Need to Know: How to Select an EHR System (and Vendor)
Adopting new health information technology is a massive undertaking—especially when that system is as mission critical as an EHR. The need to implement an EHR can emerge in a variety of situations, including:
- Conversion from paper filing process to an electronic system for the first time
- Evaluation of options as current EHR contract end-date approaches
- Current EHR does not adequately support organizational objectives (e.g., lack of customization or capabilities necessary)
- Ineffective integration between EHR and other critical organizational technologies
- Unsatisfactory working relationship with EHR vendor
Regardless of the reason for implementation, EHRs require a significant financial investment, comprehensive training across the entire organization, and buy-in across various roles and departments. It is critical that EHR selection be executed thoughtfully and carefully so as not to waste valuable time, money, and resources.
Further, the hospital or medical practice will inevitably be linked to the vendor that supplies the chosen EHR system for the foreseeable future—so it’s critical to be deliberate and vigilant in the vendor selection process.
How to Select an EHR System (With Checklist)
Before starting the process to select an EHR system, it’s important to have a clear picture of what your organization needs to meet its goals. Though the options are certainly not endless, there are several types of EHR systems available. To ensure you are choosing an EHR system best suited for your organization, keep the following checklist in mind:
1. Recruit a diverse, representative planning team: Ensure you involve users of different experience levels and perspectives, including members of clinical, executive, practice management, administrative, marketing, and support staff teams.
2. Identify key guidelines and goals: This list should include your budget, time frame, and objectives (ONC suggests using SMART goals).
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3. Set thorough requirements: Conduct process audit and mapping exercises to see (a) what is currently successful and (b) what could be improved with a new EHR product. Use the results to prioritize functionalities (e.g., critical, nice-to-have, unnecessary).
4. Design and distribute an RFP: Construct a comprehensive request for proposal (RPF) outline to explain to vendors who you are, what you are looking for, and what information you need from them. Ask for details about the company, product, implementation plan, customer care, costs, security, and more (the American Academy of Family Physicians offers a nice sample RFP).
5. Prepare for your finalists: After reviewing the RFPs with all stakeholders and deciding on a handful of vendors to continue evaluating, you can start scheduling live demos. Before walking (or Zoom-ing) in, create a standard rating form or scorecard for your committee members to complete for each demo.
6. Collect additional perspectives: Don’t stop at simply calling references. Review online industry forums, check user discussion groups, view the system in action at similarly-sized/configured organizations, and chat with connections in the industry. Try to get the most comprehensive picture—not just a highlight reel.
7. Execute final ranking and start rallying: Once your team has agreed upon its top choice (and back-ups), you may need to make the rounds with additional stakeholders throughout your organization to gain buy-in and commitment. If your practice is smaller, you may already have full agreement on the essential components of an EHR system and would not need to take this additional step.
8. Begin contract negotiations: Work with the vendor to agree upon contract length, cost, roll-out plan, support services, and more. Consider consulting with a contract lawyer to ensure the final document is airtight.
How to Select an EHR Vendor (and What You Need to Ask)
Importantly, EHR vendor selection must include evaluation steps beyond EHR features, cost, and technological compatibility. While those factors are extremely important (as you know from the checklist), you also need to consider the company’s goals, culture, and priorities.
Consider the following list of questions when evaluating your final EHR vendors:
- What do employees have to say about the company? (Hint: check Glassdoor)
- What do non-salespeople at the company think about the product?
- How have you been treated by various members of the vendor organization throughout the RFP and demo process?
- What does the company stand for? What are its mission and vision? Are your values aligned?
- Does the vendor seem to have long-term client loyalty, or is there significant turnover in the customer base?
- How long has the organization been active in the industry? Are there any hints that they might be bought out in the near future?
- What is the vendor’s security track record—and how much effort are they putting into constantly innovating and advancing the safety of health information?
When you’re determining how to select an EHR vendor from the group of finalists, the answer isn’t always found in the financial data or the features menu. When choosing an EHR, you’re doing more than picking a software—you’re committing to a partner. To make the best decision for your organization, give weight to both the information gathered from vendors and the intuition shared by your selection committee.
As mentioned above, larger or more complex organizations may want to take the time to give individuals throughout the hospital or practice the opportunity to ask questions, voice concerns, and share feedback on the front-runner. You could also work with an EHR consultant to gain additional expert perspectives on both the system and the vendor. These extra steps invite a fresh perspective on culture, capabilities, and overall fit—ensuring that no red flags are missed due to process fatigue or unintentional bias.
Mistakes to Avoid in Your EHR Selection
Finally, organizations learning how to select an EHR that best fits their needs should watch out for a few tricky decisions that hospitals and clinical practices have to make in the process.
- Installation vs. remote hosting: In the past, EHRs software was primarily installed on a computer. Now, web-based and cloud-based EHR systems can improve access, security, costs, and upgrade procedures. Thoroughly evaluate multiple vendors of both types so you can determine which route is best for your organization.
- Cost vs. quality: This debate takes many different forms in the healthcare industry. In this case, hospitals and practices evaluating EHRs will likely need to make some tradeoffs between capabilities/customer support and costs. There likely will not be one perfect fit, so ensure that your committee agrees from the start about where their hard boundaries lie and what compromises they’re willing to make.
Wrapping Up
Learning how to select an EHR system is one feat; successfully executing the entire operation from ideation to implementation is quite another. Even after the negotiations are done and the contracts are signed, there is a long road ahead. An experienced, reliable partner like True North can help your organization make the most of its EHR investment and maximize its impact.
