How to select a replacement EHR system

Selecting a replacement EHR system costs the practice time, money and resources. By analyzing and determining what is not working in your current EHR system, you should have identified a list of key requirements and now be in a position to select your new system.

A 2015 study conducted by HIMSS Analytics, reported that the number of practices replacing their ambulatory EHR system rose to 7.6% in 2015 (up from 6.4% in 2014). The study also looked at the motivations behind EHR purchases with practice efficiency, ease of data sharing and patient care coming out on top.

You can use this data to help guide your EHR replacement, but at the end of the day, each practice's motivations to replace EHR will be different.

A different process

The first thing to note is that the replacement of an EHR system is a very different process to that of selecting your first EHR system. The beauty of selecting a replacement EHR system is that you have a list of things you know to avoid. Think about the last time that you switched jobs. You know what you don’t want, even more than what you desire. Most of the time having a list of negative system qualities is more useful than having a list of positive requirements.

There will be areas where your EHR system works well and often these can become lost in the negative sentiment permeating your practice.

In addition, when replacing an EHR, you already know how the basic operations of electronic documentation works. EHR is no longer a new concept to you or your practice. You are familiar with the benefits, so you should be in a position to gloss over the marketing propaganda each vendor will present and cut to the chase by presenting requirements and backing them up with practical use cases.

What needs to change?

Begin your selection process by reviewing the legacy system you plan to replace. Review bug reports, support requests and training challenges to inform the prioritization of your newly documented system requirements. A feature which has seen low adoption or high numbers of support requests might be assigned a lower priority or increased training allocation.

It is also important to gather user feedback on the system outside of the traditional systems hierarchy. What are clinicians upset with? Why aren’t you getting reimbursed properly? Creating a problem list for system specific issues will be extremely valuable for knowing what needs to change. When conferring with vendors, give them a situational problem that your practice faces and ask them to explain how their system would handle the problem. Be specific and keep asking questions until all of your problems have been addressed.

What needs to stay the same?

When replacing EHR it is crucial to avoid throwing the baby out with the bathwater. There will be areas where your EHR system works well and often these can become lost in the negative sentiment permeating your practice. If you have performed a regular audit of your EHR system, you will be in a strong position to identify these positive system qualities. If regular audits have never been part of you process, you will have a job on your hands.

Identify what works well in your system, what your users are happy with, what features saw strong adoption and usage rates. These will be the features that you will want to ensure your new system also offers. For example, if you find that electronic appointment reminders have reduced your patient cancellation rates, then be sure that your new system offers this. You can’t afford to take one step forward and two steps back.

Approaching an EHR replacement, your practice should always be in a strong position. You know that EHR is useful to your practice. This time you are simply looking to execute the selection process a little better.