EHR Selection and Decision-Making Process

Healthcare organizations often struggle with the selection of appropriate electronic health records (EHR). Your initial search may reveal more than 300 companies claiming to make EHR.

The availability of a vast number of EHR vendors can be very overwhelming and you would easily settle for those that you have heard about. You need to have a proper plan while selecting EHR unless you want to renounce your control to the vendors.

Establishing a systematic EHR selection process makes the process less daunting. An EHR efficient process gives the healthcare organization the capacity to alleviate problems that may arise from selecting an EHR that does not align with the organization’s strategy.

A partially flawed or failed EHR selection process can introduce several issues including reduced quality of care, administrative inefficiency, poor user satisfaction, and reduced productivity. It also predisposes the organization to long-term and short-term financial losses. 

This article will provide a basic guide to facilitate successful EHR selection and decision-making. An effective EHR selection process entails information gathering and incorporating feedback from all key stakeholders to create a list of the EHR features that would best serve the organization.

By observing a systematic and logical EHR selection process, you’ll make a superior decision regarding your EHR choice. The following segment provides all the essential steps that should be followed to select the most appropriate EHR for your organization. 

Step 1: Identifying your key decision-makers

To make an informed decision about EHR selection and purchase, you will need a team of decision-makers. It would be appropriate to select a committee with well-defined roles in the EHR selection process.

Having a ‘physician champion’ who is committed to the process is recommended. The physician should not only be willing to learn more about the EHR selection process but also promote the idea to the rest of the team members.

To ensure seamless buy-in, it is key to include the most influential personalities in the selection committee. The most influential people are not necessarily those with prominent titles but those who more people tend to listen to even without the presiding authority. 

Step 2: Assessing your EHR needs and setting EHR goals

You should focus on the limitations or inefficiencies in the organization and how EHR implementation would help to counter them. Identify the high-priority needs and EHR features that align with those needs. You should set “SMART” EHR goals that you intend to accomplish with the EHR implementation.

Step 3: Preparing a Request for Proposal

A Request for Proposal (RFP) introduces your organization to the prospective EHR vendors. You should include details about your resources and priorities regarding EHR functionality. Serious vendors will respond to your RFP and you can easily compare their products.

Step 4: Selection of the RFP recipients 

With more than 300 EHR vendors, it is prudent to develop some criteria to use in determining your RFP recipients. Some of the factors to consider include the favorability of the EHR’s published ratings, the practice size appropriate for the EHR, and the EHR having a history of interfacing with your practice management system (PMS). Send the RFP to vendors who meet this criteria.

Step 5: Reviewing responses and narrowing the field 

While reviewing the vendors’ responses to your RFP, the focus should be on picking the top contenders who align with your EHR needs and organizational strategy. Your top choices should provide a demonstration of their system to the selection committee and comparisons between the products made. 

Step 6: Attending vendor demonstrations

During the vendor demonstrations, use a rating form to rate each vendor. Some of the key functions to look out for include the ability of the EHR to allow users to find information, write prescriptions, manage health maintenance reminders, view labs etc. 

Step 7: Scrutinize the vendor’s list of references  

A good reference list should include a senior management person, an information technology (IT) person, and physician users. Contact some of these references and ask them about the product.

Step 8: Comparing and ranking vendors 

After reviewing the RFPs, attending demos, and conducting reference checks, you should use this information to compare and rank the vendors and narrow down to at least two or three for site visits.

Other key areas to consider when comparing vendors include their characteristics (including their service, training, and implementation support provision); total costs for support, software, and hardware; and the product functionality.

Step 9: Conducting site visits

You should plan visits to organizations that have the same configuration and size as yours to establish how the systems perform. Bring along physicians to help establish how the product works with patients.

Ask relevant questions to key personnel such as IT and back-office personnel and determine whether the product is meeting your predetermined expectations.

Step 10: Making the final decision

After the site visits, you should have adequate information to select your top two vendors. The runner-up should be as a back-up option in case negotiations with the top contender don’t go well.

Step 11: Discuss your decision with key stakeholders

At this point the focus is to sell the selection committee’s recommendations and vendor choice to the rest of the team. The vendor should be invited to give another demo to the entire organization and the team’s concerns and questions addressed before solidifying the organization’s commitment to the EHR.

Step 12: Contract Negotiation 

An ideal EHR contract takes 10 years. In case of an unforeseen termination, the consequences should be explicitly stated. The role of the vendor as well as current and future costs should be spelled out. You should consider using an experienced software contracts lawyer to facilitate this step.

Overall, while the process is complex and the decisions are tougher, you wouldn’t want to select a EHR that would fail you. Using this guide will help you make informed decisions to ensure that you select the appropriate EHR for your practice.

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