Selecting the Right EHR

Objectives:

  • Learn about the different products available
  • Learn about different discussion boards available for networking with other EHR docs
  • Learn how site visits and office demonstrations can help in the selection process

Select the Right Electronic Health Record for Your Practice

Developing an EHR Evaluation Matrix

An evaluation matrix is a simple grid. Across the top are the criteria you want in your EHR and down the side are the EHRs you're considering. You can enter the information about how each EHR meets your criteria and easily compare products. You can also send the empty matrix to each vendor you are considering and ask them complete it.

When EHR certification standards become a reality in the not-too-distant future, it will be easier to evaluate products based on their functionality. Then the evaluation matrix becomes easier and criteria such as vendor stability, compatibility, and interoperability will move to the forefront of the evaluation process.

Understanding EHR Demonstrations

Several options are available to see an EHR demonstrated. Each method has its pros and cons, and you may choose to use more than one in your evaluation process.

Non-interactive video: This requires the fewest resources from the practice, but it is also offers the least benefit. This type of video can give you clues into the complexity of the user-interface and a glimpse into the functionality. Keep in mind that the video was produced by the vendor to showcase the best of the product and what the vendor thinks is important. This type of demonstration is useful when your EHR list of contenders is long.

Interactive trial demo: This requires more time compared with non-interactive video. Your goal during the demonstration should be to gauge the ease of use. The questions you want answered are:

  • Is the product intuitive?
  • Is it easy and quick to perform repetitive tasks (e.g., writing a prescription)? 
  • Is it easy to find specific patient information?

Vendor directed demo: This will require more time than an interactive trial demo and you will need to schedule it with the vendor. Your goal during the demonstration should be to understand the true functionality available in the system. (If you have not already had an interactive demo, you will need to answer those questions as well.) Come prepared with your list of criteria from your evaluation matrix. You want to see how the functions you require are accomplished. Also bring any issues you uncovered during the interactive trial demo.

Besides the functionality, you want to see the workflow. The easiest way to accomplish this is to bring some clinical scenarios that mirror what you see in practice (e.g., acute visit for URI; chronic disease care for new and follow-up patients; routine visits such as annual or well child exam). Study how these mock patients flow through the system and how the data is entered and viewed by front desk, nurse, physician, billing, etc.

Live site demo: This requires the most resources from the practice, but offers the largest reward in terms of getting data about an EHR. Because of the time, travel, and money involved in this type of demonstration, many physicians limit these to their final few contenders. To set up a live site demo, you first need to find peers like yourself that are using the EHR in their practice. You can ask the vendor to give you a list of family physicians using their EHR in your region. By asking a vendor for a list, however, you accept the likelihood that these users are happy with their EHR– since it is in the vendor's best interest. You can mitigate this by doing two things:

  1. Ask for a list of ten to 20 users
  2. Briefly interview the users by telephone before scheduling a site visit

Asking for such a large list and interviewing users can help you find some who may have had a problem with the EHR. You want to ask questions about how they deal with negatives of the system and how well they can explain the functions of the system. This demonstration should build on the previous demonstrations. If you have the resources, doing more than one site visit for a particular EHR is beneficial.