Thursday, July 19, 2007

Helpful Advice When Choosing an EMR

There are many electronic health records and electronic medical records software packages on the market, and in some cases, the variety of software options makes the selection process overwhelming. Here's some advice: Don't choose an electronic medical record (EMR) software system before reviewing these helpful tips!

Vendor Software Licenses: When you purchase an EMR or EHR system, part of the price almost always includes a software license. These licenses usually take one of two forms - concurrent or named-based. If your EMR is one of the new ASP (monthly rental agreement) based systems, you don't really purchase a software license. Instead, you rent the license, usually for a low fee. However, the same issues exist for determining the number of ASP licenses as with a traditional EHR license purchase.

Possible Red Flags:

1. The EMR software vendor doesn't specify the type of license ini the quote.
2. Software functionality is not specified.
3. The EHR company doesn't specify the period of time the license is in force.

Interfaces: Software programs that allow data from the electronic health record system to flow back and forth between external applications. These applications can either reside outside the physician practice (think lab applications) or can be
another system within the doctor's office, such as a medical billing system.

Possible Red Flags:

1. One-way or two-way interface is not specified.
2. The EHR's data format is not specified (structured or non-structured).
3. Additional license costs, if any, not specified.
4. The EMR company promises an interface, but it is not currently available.

Clinical Documentation Features to Consider When Selecting an EMR or EHR System

Implementation Services: Consulting services offered by the electronic medical record vendor. These services will provide planning and actual implementation of an EHR software system for the physician practice.

Possible Red Flags:

1. The EMR vendor can’t commit to a project plan with milestones.
2. Only the EHR vendor can customize templates.
3. Software implementation is not broken into small enough tasks.

Training Services: Consulting services offered by the electronic health record company. They provide hands on training for how to use the EMR in the physician office.

Possible Red Flags:

1. There is no cost listed for future EHR training.
2. The EMR vendor offers no formal training plan.
3. There is no definition of what training expenses will be reimbursed, along with limits.

Support and Maintenance: EHR support and maintenance costs typically represent 15-20% of the software license fee. Where the actual license are often a one-time fee, the support and maintenance costs are renewed on a yearly basis. This yearly fee
basically covers two areas: 1)any upgrades or new releases; and 2)customer service and support. If you select an ASP-based (web-based) electronic medical record system, you don't usually pay a yearly support fee because those services are built into the monthly rental fee you pay for the medical software.

It should be noted that both vendor EHR software and third party EMR software will need support, so it is important to determine which components the support costs cover. Also, some EMR/EHR vendors might have more than one service level agreement representing different support options at different costs.

Potential Red Flags:

1. No support agreement from the electronic health record company.
2. No guarantees of service or reliability.
3. No cap on renewal percentage increases.
4. No software escrow costs offered.
5. The EMR company charges extra for database schema.
6. There are added maintenance costs for third party products.
7. The EHR company will not offer support for third party products.
8. No support offered for previous EHR/EMR software versions or releases.

Payment Terms: EHR implementation typically involves a number of phases and takes time. Things can go wrong. Therefore, the payment terms should reflect milestone-based payments. This means should pay the EMR vendor percentages of the total as major parts of the project plan are successfully completed.

Potential Red Flags:

1. The electronic medical records company wants all or most of the payment up front.
2. The EMR vendor is not willing to agree to final payment when system is accepted.
3. The EHR company has no policy or process for payment refunds or reductions.

A Business Case for Electronic Health Records

Service Level, Hours of Support: Most EMR or EHR companies will offer several ways to communicate and resolve software problems. Typical methods include email, telephone, and online chat. In some cases, a specialist will visit the physician office to help resolve an issue with the electronic health records software. Ask whether remote diagnostics and/or on site visits by support analysts are available.

Potential Red Flags:

1. “Normal business hours” are specified instead of detailed days and hours.
2. The company offers no "after hours" support to physicians.

Financing Alternatives: Electronic medical record or electronic health record systems can be expensive, depending on the type of medical software system you choose. (The exception is when you buy an ASP (web-based or online-based) EMR, where the physician user pays a monthly fee instead of an up-front license fee.) EHR or EMR vendors should offer you the option of leasing or financing your system.

Potential Red Flags:

1. The EMR company passes you off to a third-party finance partner and is not involved in the process.

Editor's Note: The terms "Electronic Medical Records", "Electronic Health Records", "EHR" and "EMR" are used interchangeably in this article. For more information like this, click here.

No comments: