How to select an EHR vendor


Practices often struggle regarding how to select an EHR. One tried and true way to overcome this difficulty rests on establishing a thorough EHR selection process. By using a reliable process that can gather information during the selection, practices can avoid a number of the pitfalls that come with selecting or replacing an EHR.

An effective selection process is an information gathering process; it establishes a selection criterion that incorporates input from all stakeholders in a practice to generate a list of EHR features that best contribute to a practice’s goals. From this point, a list of EMR systems that meet this criterion is created.

The first step in this process involves requirements gathering or a process of determining a practice’s EHR system requirements. Without a rigorous requirement gathering process, the selection process will suffer due to a lack of direction and focus. A requirement gathering process should produce the selection criterion in which a practice can evaluate an EHR vendor. During this process, EHR selection teams should consider a number of factors that are deemed appropriate, the most important of which are discussed below.  

Use our free, customizable EHR requirements template to start your selection project off on the right track.

Factors to consider when choosing an EHR system

Unfortunately, there is not a universal, one size fits all recommendation practices should follow when choosing an EHR system. Rather, practices must first consider how individual circumstances will define the EHR product they will choose. A practice should determine whether an EHR is appropriate for the size of the organization. An organization should not only consider whether an EHR fits within its budget, but also whether the system’s workflows are designed to accommodate a practice’s volume of patients. As such, a facility should review all available resources to assist during the vendor selection process, in order to be certain an EHR is an appropriate fit.

In a similar vein, during the selection process practices should also consider whether they want an on-premises or cloud-based EHR. On-premises EHRs require physical space to accommodate the necessary hardware, dedicated IT staff, and require an upfront investment in the required hardware, whereas a cloud-based system does not require a practice to dedicate space and capital toward on-site hardware.

Lastly,  it is important for an organization to consider which system has the best tools for patients. The level of importance this has will depend on services offered and the type of patient population being served. Some types of practices require a greater level of patient engagement through a patient portal, whereas others may find other patient-centered features such as electronic registration or appointment reminder features are a better investment.

EHR security measures

Security considerations factor heavily in the EHR selection process for two reasons. The first, and most obvious, rests on the fact that organizations have a legal obligation to properly protect patient health information. Secondly, a data breach is costly. According to the Ponemon Institute, a data breach, on average can cost an organization over $5 million in lost system downtime, and loss of information assets. Accordingly, a significant part of the obligation to protect patient health information involves selecting an EHR that is designed in a way that offers adequate security.  

Questions to ask when selecting an EHR

Once the EHR selection criteria has been established, the selection team should generate a list of questions that can be directed to vendors to assist in the EHR selection and decision-making process. Although the list of questions that can be asked is not limited, important questions that should be asked include:

  1. What is the total cost of ownership for this product?
  2. What security features does the product offer?
  3. What type of support is offered with the product?
  4. What type of assistance does the vendor provide during implementation?
  5. How are updates and other add-ons handled by the vendor?

Planning the selection process is one of the most important administrative tasks a practice can undertake given the costs of not making the right decision. Therefore it is important to have a set of clear objectives in mind, but also understand how to ask the right questions in order to make the information gathering process as rigorous as possible.

How to select an EHR system: a quick step-by-step list 

Selecting an EHR system can be a daunting process even for those who have experience in the area. However, the process can be made less daunting when it is viewed as a process that can be broken down into smaller manageable steps.  As a process, it is important to understand the goal that is to be achieved. Here the goal is the selection of an EHR product that is aligned with an organization’s clinical and administrative goals while being a good fit from a financial perspective. In effect, the right selection is one that further practice’s goals and provides a suitable return on investment over the short term and long term.

With the goal of the selection process in mind, what are the steps needed to select an EHR vendor? The steps in the selection process can be divided into the early organizational phase, the information gathering and evaluation phase, and the decision phase. 

Early organizational phase 

1. Assembling the selection team: a selection team consisting of key stakeholders must be assembled.
2. Assigning roles and responsibilities on the selection team: on the selection team, individuals should have designated roles and responsibilities related to the steps in the selection process.  
3. Goal and milestone setting: in this step, the overall goals for the selection process are established along with the objective milestones to gauge progress. 

Information gathering and evaluation phase 

4. Generate a requirements list: a requirements list is generated by surveying members of the organization to determine what features and functionalities will help the practice achieve its goals. 
5. Prioritization of requirements: the requirements list is then prioritized through further surveying of key stakeholders who determine a ranking of requirements.
6. Research vendors: the selection team should conduct preliminary research to determine which vendors meet their general criteria and should receive RFIs.  
7. RFPs: after collecting information from RFIs vendors who best meet the requirements criteria are provided with RFP to submit proposals to deploy their EHR product.    
8. Evaluation of RFPs: RFPs are evaluated based on how well the product aligns with the organization’s prioritized requirements list. The best matches are shortlisted and called to provide a demonstration of their product.  
9. Demonstrations: the selection team hosts vendors for product demonstrations.  
10. Evaluating demonstrations: the information from vendor demonstrations is compiled and evaluated on how well it aligns with the prioritized requirements list. Once this information is compiled it is submitted to the selection team for a decision as a group. 

The decision phase

11. Deciding on who should get the contract: after all the information is in and deliberated either designated members of the selection team or the entire group decides on which product will be chosen. 
12. Contract negotiations: the vendor is informed that they have been selected. The vendor and the practice’s representatives negotiate the terms of the purchase of the EHR product. If an agreement cannot be reached other suitable vendors are contacted and the process repeats.  

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green

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