EMR & EHR Blog for Physicians

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Is the EMR software you recommend CCHIT Certified?  This is one of the most common questions physicians ask me during a first EMR Software Consultation.  My answer is, “of course” that is, until HHS recognizes another organization accredited to certify EMR Software. So while being CCHIT Certified is a good requirement to strongly consider in your search for a good EMR, it should not be used as the all encompassing endorser of every EMR Vendor you come across in making your final decision.  So what else can one do to go beyond the certification process?  Well, you can take it to the streets, so to speak.  That is, where do you go to find out how well an EMR software you may be considering is working or what are the most common criteria being used to grade EMRs in the real world of Medical Practice?

There are several well recognized grading or ranking organizations that compare EMR features and functions, survey and interview end users, and conduct performance tests of EMR Software. These results can be used by physicians as a practical “Report Card” to assist them in evaluating EMR Software and EMR Vendors.

Essentially, physicians in Ambulatory Practices of all sizes can use this information as an additional screening tool to further narrow down their selection list to include EMR Software that has earned excellent scores for their unified Electronic Medical Records (EMR) and practice management (PM) solutions as it pertains to their individual requirements.  

Here are a few of the well recognized EMR Software rating or ranking resources and examples of the information they can provide:

IDC Health Industry Insights

This IDC Health Insights report discusses ambulatory EMR functionality for small and midsize practices with 20 providers or less and presents an assessment of the offerings of 10 vendors that serve this space. This report considers the requirements and cost relief provided by stimulus payments under ARRA, alongside additional assessment criteria that consider results from EMR including the migration from paper charts to electronic documentation, electronic ordering, charge capture, and improvements to patient safety and the quality of care.

TEPR

TEPR Awards identify outstanding health information technology and electronic medical record (EMR) innovations and solutions.  Physicians can use this information to identify EMR Software that has received the highest scores available in important areas including pricing, implementation cost, features and functions, references, support and maintainence, and overall customer satisfaction.

The TEPR Documentation Challenge is one that you may hear many vendors touting about and that ranks their EMR Software for their charting abilities and speed compared to manual charting.

 KLAS

You have probably heard this phrase used a lot: "Best in KLAS" Awards. This is an annual competition amongst EMR Vendors to determine the “Top 20 Best in KLAS” awards report.

KLAS helps healthcare providers make informed technology decisions by offering accurate, honest, and impartial vendor performance information. KLAS independently monitors vendor performance through the active participation of thousands of healthcare organizations. KLAS uses a stringent methodology to ensure all data and ratings are accurate, honest and impartial. Research results are offered to healthcare providers through:

• A free directory of vendor and product information

• Free online access to vendor ratings for participating providers

• On-depth published reports, discounted for participating providers

AN IMPORTANT CAVEAT to mention here, is that not all EMR Software on the market are evaluated and therefore, even this information should not be wholly relied upon as the "super-list " of EMR Software options available to you. There are many EMR Vendors that have not been evaluated by one of these organizations, but if they were to be put to their tests,  they would rank high and pass with flying colors.  So, if you are considering an EMR Software that may not be on the “A” list of one or more of these reports, the more important take-away from these evaluating organizations is to make good note of the major  categories and criteria that are being assessed and make them a part of your evaluation process when comparing EMR Software and interviewing EMR Vendors. 

Also worth mentioning, in a majority of cases, EMR Vendors actually pay to have their EMR Software included in thsee independent assessments.  Now you can make your own conclusions here but, that does not necessarily mean there is anything under-handed going on. 

So, to the extent that an EMR Vendor is being evaluated by one of these reputable organizations, use this information more as another good reference resource throughout your EMR screening and selection process.

My best advice, find a good EMR Consulting company to help guide you in the right direction for finding and comparing EMR Software.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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The term "system" originates from the Greek term syst¯ema, which means to "place together" and defines a system as an integrated set of interoperable elements, each with explicitly specified and pre-defined capabilities, working seamlessly to perform value-added processing to enable a user to achieve set objectives.

An EMR System includes these basic components:

1. Infrastructure- Physical and hardware system components, for example, Workstations and Servers, Tablet PC, Laptops, Monitors, Scanners, Routers and Bridges, etc.
2. Software- Application software (EMR Software or EHR Software), Operating System software, utilities, and other applications like Instant Messaging, Fax Servers, Networking Software, Lab interfaces, ePrescription, etc..
3. People-Personnel involved in using, maintaining or managing the EMR - this includes the clinical and administrative staff, Physicians, etc . These personnel need to receive appropriate level of training.
4. Business Processes-Guidelines, instructions, and steps involved in keeping the EMR System running smoothly. This includes patient appointment scheduling, reminders, billing, etc.
5. Data-Information captured, used, and supported by a system, including documents, images and databases.

It is clearly evident that EMR software is just one component of an EMR System and is therefore a subset of EMR System. It is not good enough to assemble motley of ill-fitting components to create an EMR System since they may not work seamlessly and will certainly not perform value added processing.

So what are the implications from a Physician's perspective?

When Physicians buy EMR Software from EMR Vendors, they typically get the following:

1. EMR Software (application software)
2. Application Database
3. Configurable Lab and Pharmacy interfaces
4. Specifications of recommended commonly required and used hardware

To take the above and convert this to a fully functioning EMR System takes skills of different kinds - technical and functional. Also as you can see, unless you take the required steps to create an optimized System that performs value added processing, you shall not get the required Return on Investment (ROI).

Physicians are expert at providing quality healthcare to their patients but do not have the necessary expertise to assemble all the components to build and implement the EMR System. By working with an expert EMR Consulting company or an EMR Systems Integrator to build and integrate all required components of a customized EMR System, you can ensure successful implementation and reap maximum benefits from EMR Software deployment.

(Research Support provided by: Om)

RevenueXL can assist you in deriving maximum ROI from your investment in EMR technology by converting your EMR Software into a fully functioning EMR System. Contact us right away for a Free Consulting Session.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Medicare payments to physicians not qualified as “meaningful users” of Certified Electronic Medical Record software will be reduced by 1% in 2015, then 2% in 2016, 3% in 2017, 4% in 2018, and by as much as 95% in subsequent years.

To avoid this situation your timing is critical. Experts predict that by mid-to-late 2010, the demand for Electronic Medical Record Systems may far exceed the number of qualified sales and support staff that companies with Certified Electronic Medical Record software will have to meet the last minute rush of physicians suddenly realizing their forthcoming financial misfortune. Therefore, now is the time to take action and give serious attention to the 2 to 4 months of lead-time required for planning and selection, set-up and training, implementation and “go live”. Then, add an additional 6 to 8 months to ensure physicians and staff are proficiently up and running as “meaningful EHR users”, so that each physician in your practice is eligible for the up to $44,000.00 in Medicare Incentive Payments beginning in January 2011.

Late adopters can surely expect huge delays or worse, being placed on a waiting list (at least by the best and most popular EMR software vendors).  In this case, your options may become very limited, and prices may even increase.  So, instead of receiving Bonus Payments, you may wind up being penalized through reduced payments.  Don’t be surprised if you find yourself on a “hotchpotch” path of trying to force-fit poorly matched EMR and Practice Management software together from different vendors. This predicament will cost you a lot of time, frustration, and money.

There are over 300 EMR vendors on the market, and only a few are CCHIT Certified and qualified take on the question, “Which EMR has the smoothest transition and implementation that meets the requirements of your practice and, ensures each physician in your practice receives the maximum Medicare Incentive payments?” The answer, find a good Independent Consultant who, at no cost to you, can help you find the best-fit Certified Electronic Medical Record software, which has all the answers “built-in”.   

It’s not everyday the government imposes new laws, regulations, costs, and penalties upon your business and then, turns around and pays you, to become compliant and avoid being penalized. Now is the time to start positioning each provider in your practice to leverage every Bonus Incentive dollar available. After all, the right-fit Electronic Medical Record software will make running your practice easier, more profitable, boost morale, improve patient care and, enhance your quality of life and that of your patients.  Everyone will “feel” the difference.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Stories abound about botched EHR System implementations and providers uninstalling EHR Systems in Arizona. But at the same time, there are many case studies which prove that achieving ROI with EMR or EHR is very much possible, provided there is right focus on training, transition and implementation.

Computation of ROI with EMR Software is a complicated business, based on many assumptions and unquantifiable and intangible benefits. I personally like the definition: ROI = Increase in Revenues - Decrease in costs. I recently come across another definition: ROI = EMR - FTE based on the consensus that automated systems alleviate support staff needs. You can choose whatever definition appeals to you most.

According to "The formula for EMR: ROI=TCO?", if the average physician needs 4 assistants, implementation of an EMR can reduced that number by one or more. In a fast growing practice in New York State, which implemented an EMR, it was able to grow from 20 to 120 doctors in just two years because they only had to hire two or three FTEs per doctor instead of four or five.

In a recent case study published by HIMSS, Glynn Medical Associates, comprising of four internists, two rheumatologists and a physician's assistant, which implemented an integrated EMR/PM system with every provider using the system as of the first day, experienced savings conservatively estimated at $200,000 per year. But the ROI did not come easy. The first three months of going paperless were stressful. Also, one physician in the practice was seeing 33 percent more patients daily with use of the EMR system helping to increase patient satisfaction.

Some of the quantitative benefits included:

• Reduction in transcription costs.
• Reduction in medical records personnel
• Reduction in billing department personnel
• Possible downsizing of facility

In another case study, according to Wellesley, Mass.-based Nuclear Research, a 76-bed hospital in Bolivar, Mo achieved a 1,321 percent ROI in its first year after implementing an EHR Software solution, besides reaping other intangible benefits. Over three years, the hospital's ROI came in at 2,912 percent.

Here are two EMR Calculators that you can use:

1. Physicians Practice EMR ROI Calculator
2. HIMSS EMR ROI Calculator 

Experts say that an EHR implementation project is not a sprint but a marathon. Moreover, the race does not finish on the go-live date. You will see reduced productivity during period immedialtely followng post-activation followed by "stabilization" and then "optimization".  If everything goes right, you can achieve stabilization within 90 days. After that, the financial benefits will materialize gradually as staff increasingly utilizes the EHR Software and associated workflows. 

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There are many opportunities for revenue enhancement as well as cost reduction which will yield Return on Investment. Download our free article on 'Does EMR increase Revenues?'.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Now with the Obama administration pumping in money in healthcare by incentivizing Physicians implementing certified EHRs and demonstrating meaningful use, many EMR vendors are again proclaiming the demise of Medical Transcription stating that after implementation of EMR / EHR Software, the Physicians can eliminate use of Medical Transcription services altogether.

While I agree that the role and nature of medical transcription will change in the new world, I do not believe that physicians and clinics can stop using medical transcription services altogether.

EMR solutions are based on point and click templates and capture data as discrete data elements. However, to any one intimately familiar with the nature of dictations and transcripts, it is obvious that there is a narrative part of the medical note which tells what the doctor is thinking during the patient encounter. How will this narrative be captured as part of eletronic medical records?

It has been shown that such narrative contributes to a detailed electronic medical record and supports meaningful use of the EHR. The narrative can either be produced in real-time using speech recognition software like Dragon, or it can be produced on the back end using traditional digital medical transcription services and input into the EHR by the transcription editors.

In a survey carried out, over 75% of the respondents indicated that they are interested in productivity aids that would help doctors to better document care within an EMR (beyond the standard point and click). Even though the accuracy of speech recognition software has improved significantly and it can be trained, most physicians find it a distraction - imagine the physician seeing the software wrongly transcribing and repeatedly interrupting his dictation to correct the transcript using keyboard and mouse - and do not want to take on the editing responsibilities.

Speed of charting has been one of the main sticking point with the physicians who complain that the EMR slows them down. Dictation is still the preferred method for physicians to document encounter notes. A possible solution that partly alleviates the concern of the physicians is to have the Medical Transcription Company introduce XML tags (in a semi-automatic manner), make the data elements ready for abstraction and then load the same into the EMR Software's database as discrete data elements. I would like to get feedback from readers if they have seen this technology solution successfully deployed.

According to Jay Cannon, EHR vendors need to work closely with the Medical Transcription service providers to deliver "hybrid clinical documentation solutions" that give physicians flexible choices for input, along with discrete, reportable data output for the EHR. I completely support this philosophy.

Our recommendation would be for prospective EMR customers to ensure that the EMR Software allows for an easy and unobtrusive interface for the provider to dictate and for the Medical Transcription Company to come in and transcribe right into the EMR or load final and structured documents into the EMR.

Do let us know of your comments and / or experience with implementing such a solution successfully.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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What is the difference between an EMR and EHR? Aren't they essentially the same?

It is easy get confused by the inconsistent way these terms are bandied about in the industry.

• Nextgen mentions both EMR and EHR in its home page title, but the product is called Electronic Health Records.
• GE Healthcare calls its product as Centricity EMR.
• Greenway characterizes its PrimeSuite product as an EHR.
• Aprima's PRM product was initially labeled EMR but is now described as EHR.
• eClinicalWorks continues to refer to its product as an EMR.
• Allscripts mentions both ‘Electronic Medical Records (EMR)' as well as ‘Electronic Health Records (EHR)' in the title of its home page, but their solution is called ‘Electronic Health Records'.
• CCHIT certifies EHR (Electronic Health Records) products, but the list of CCHIT-certified EHR products includes a number of ‘EMR' products.

As is clear from the above, vendors have been using the two terms - Electronic Medical Records (EMR) and Electronic Health Records (EHR) - interchangeably in their communication even though these two terms are technically different with different sets of features and capabilities.

Chris Hobson in a article published in ‘Advance for Health Information Executives' says that the difference between the two terms more than semantic and is crucial for health IT decision-makers to understand the difference.

So what is the difference between EMR and EHR? Let us review the distinction portrayed by three authorities in their own rights:

1. Chris Hobson:

The essential difference between EMR and EHR lies in how the (electronic) data will be used or shared - within the confines of a single office or practitioner or will it be shared across a wide range of different providers, such as specialists' offices, labs, insurance providers and government agencies?

Chris relies on the definition advanced by HIMSS and accordingly, an EMR is a set of applications and workflow tools that digitizes the creation, collection, storage and management of patient information "within the confines of a single organization". It may touch clinical data repositories, lab applications and patient information management systems, among others -- but all within the reach of a single organization.

EHR, on the other hand, is a longitudinal, complete and unified view of electronic record of patient health information produced by clinical assessments in one or more care settings drawn from across a wide region corresponding to all the providers who are seeing the patient -- the totality of his/her personal data, state of health and delivered care.

According to Chris, while both EMRs and EHRs provide some similar benefits -- cost savings through improved workflow and paper reduction, improved delivery of care accuracy -- EMRs provide those benefits only within a single organization. EHRs, because they are shared across the irrelevant geographic or otherwise defined region, increase the efficiency of patient care and improve patient outcomes, disseminate information rapidly between care providers, help with research efforts, and cut costs throughout the entire system more promptly and reliably.

2. National Alliance for Health Information Technology (NAHIT):

NAHIT while offering the following definitions, generally supports a similar distinction between EMR and EHR:

EMR (Electronic Medical Records) is an Electronic Record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization.

EHR (Electronic Health Records) is an Electronic Record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.

3. Healthcare Informatics:

EMR is a computerized legal clinical record created in Care Delivery Organizations (CDOs), such as hospitals and physician offices, and used and owned by the CDO. It becomes an EHR (Electronic Health Record) when:

• Reports and histories (labs, pharmacy, radiology, consults, etc) are electronically added;
• Items in the record are electronically exchanged with other providers, and
• There is a personal health record (PHR/PMR) component which allows patients to participate in documenting and creating their medical history and communicate with their provider.

EHRs represent the ability to easily share medical information among stakeholders and to allow it to follow the patient through various modalities of care from different CDOs. Thus EHR offers a holistic approach to patient care where continuity of care is emphasized.

EMR vs. EHR - What does it mean to you?

Regardless of whether vendors call their products EMR or EHR, what should your first priority be?

When selecting an EMR or EHR, ask your vendor to explain how its solution will support your vision for interoperability and rapid exchange of data between care providers, in order to provide a holistic perspective on delivering health to your patients. It's that simple. You can safely make this your criterion for choosing a system, and forget about what the vendor calls its product. For your purposes - providing efficient, effective care - the name is totally irrelevant.

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Read our related blog on Top 12 EMR Software Selection mistakes often committed by Physicians.

Contact Us for free no-obligation EMR / EHR Selection Consulting and Demo.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Web-based EMRs have been touted as a nice way to implement EMR solution with low initial investment. Web-based and client/server EMR systems have unique advantages and disadvantages. Which model you should choose for your practice will depend on your special requirements.

Despite the obvious advantages of web-based EMR (access from anywhere, remote hosting, etc.), there are some important points you should consider when deciding whether to implement a web-based system:

1. Don't imagine that a "high-speed" Internet connection is all you need to run a Web-based EMR. It's important to find out if you'll actually have the bandwidth required to send, receive, and exchange data efficiently. Consult the EMR vendor about its requirements, and talk to your Internet service provider about its available bandwidth options.

How much bandwidth you need will depend on the number of users and the volume of data flowing between your practice and the hosted Web- based EMR. If the data increases, you may need additional bandwidth, and you'll need to be prepared. Carefully review the EMR vendor's recommendations before you sign up for a bandwidth plan.

2. How reliable is your Internet connection? This is critical - and also, your upload and download speeds may vary depending on the time of day and how much bandwidth is being used by nearby businesses. You'll want to plan for extra bandwidth to avoid slow-downs in charting your patient encounters.

If you share an Internet pipe with other businesses in the same complex, your data transfer speeds may fluctuate dramatically, depending on how the others businesses are using the connection. We recommend asking your Internet service provider for documented evidence of the uptime you can expect. Depending on the answers, you may want to consider getting a dedicated pipe for your clinic. Work with the EMR provider to develop a backup system for charting on paper if the system goes down, and develop your office processes accordingly

3. What if your EMR vendor folds its tent? Will you be able to retrieve your data from the vendor's servers? Will the data be in a format that you can use/convert/transfer?

After deciding on a web-based EMR vendor, treat the vendor as your partner. You should be able to discuss every possible scenario with the vendor's sales reps. Better yet, work with an experienced EMR consulting company who'll help you communicate with the EMR vendor. Consider asking the vendor to provide data-backup files on a regular schedule.

4. Unlike a client/server environment, where you have local control over the server and EMR software, a web-based EMR makes you dependent on the vendor's customer support. Will your vendor reliably and promptly support you and your staff by phone, IM, email, or chat? Will the vendor be available to quickly help you solve urgent or critical issues? Talk to the vendor about its support structure, especially outside normal working hours.

5. What will happen if you someday decide to move from a web-based to a server-based EMR? Does your vendor offer that flexibility? If so, how seamless will the migration be? How much will it cost? Even if you don't believe it will ever happen, it's in your best interest to discuss it with the vendor today, and get an in-depth understanding of the process.

We've seen many successful web-based EMR systems. They do work well for most physicians. By understanding the handful of caveats we've outlined above, and preparing accordingly, you'll stand a better chance of implementing a successful web-based EMR system for your practice.

Learn about the top 10 EMR Software features that you should be looking for. Download our free article on Top 10 Electronic Medical Records features for every physician.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Here's a multiple-choice quiz with an answer that may surprise you:

What's the most expensive cost element when you implement new Electronic Medical Records?

a. EMR Software
b. Workstations and monitors
c. Training and Change Management
d. Customizing templates

If you answered "EMR software" - sorry, no cigar. While EMR / EHR software isn't cheap, it's a one-time expense.

If you chose "Workstations and monitors" you're still on the wrong track. Workstations and monitors with more than enough power for EMR cost under $1000.

If you answered "Training and Change Management," you may select the kewpie doll of your choice - you're absolutely right. This cost component is perennial and has no end!

Why is that true?

1. We've discovered that new staff usually needs to be trained not only on the EMR application, but also on basic computer skills like Windows, use of mouse, printing, creating folders, moving files, logging on and off, etc. If your staff is not comfortable with using computers with GUI (Graphical User Interface) for day to day operations, they will surely need training on that.
2. Implementation of Electronic Medical Records would involve use of devices like scanners, fax servers, etc. If the Clinic does not use such devices currently, staff will need to be trained on using these devices.
3. EMR software is a major application, thus most users will need to learn multiple new software functions. This takes time - learning a complex application requires lots of repetition until the new skills become second nature.
4. Initial training is often conducted in a tight time frame where the schedule is dictated by the EMR vendor and clinics find that they need additional training.

Here's another quiz question: what's the leading cause of failure for new EMR implementations? Studies show the failures are primarily related to inadequate training.

Clients often want to know the quickest, most cost-effective way to train their staff on EMR software. By avoiding the following 8 Cardinal Sins of EMR Training, you'll significantly slash your training costs, and improve your return on investment.

1. Big time gap between training and 'go live'

We've seen cases where the EMR vendor rushed ahead and trained staff on using EMR, even though the provider enrollment with various payers was far from complete. Big mistake! The training vendor went through the motions of training, collected a nice check, and went away. When the enrollment process was finally completed, 8-10 weeks later, and the clinic began using the EMR system - you guessed it, the provider and staff had forgotten how to use the application and were forced to purchase additional training days.

Here's our recommendation: insist on starting training after the setup process is complete, including all interfaces (lab interface, eRx, etc.).

2. Training everyone on everything

In a larger clinic (including multiple locations), clinic staff often play widely different roles, and therefore need to know very different parts of the EMR application. Training every staff member on every feature of the EMR won't optimize their skills on the parts that are most relevant to them. For example, only a few staff members will have access to the sensitive areas of the EMR (e.g., security administration).

Training plan must be based on roles. A better approach is to have the EMR vendor train a set of super-users ("Train the Trainer") who will have the responsibility to train and support the rest of the staff. They are the ‘go to' people when users have issues with using EMR (before someone makes a call to the Customer Support operations of the EMR vendor).

3. Assuming that training ends after implementation

Training doesn't end when the EMR system is up and running. Staff roles and responsibilities can change over time, and new employees will need training on the EMR software. Training never ends - but it's a lot cheaper to have one or more super-users on the staff who can train than others, than to bring back the training vendor each time. (See #2 above.)

4. Having the EMR vendor train staff in basic computer skills

Having the EMR vendor teach basic computer skills is a huge waste of money. If your staff members can't teach each other these simple skills, find an adult-education course, or hire a computer science student who'll do the job for a fraction of what the EMR vendor would charge. Plan to have the hardware installed well in advance, so that staff can be trained on basic skills before the EMR system arrives.

5. Assuming that training can be imparted remotely and effectively over Webex or other web conference media

Many EMR vendors offer remote training using remote Webex or GoToMeeting sessions over the Internet, without any on-site support during go-live. Remote training costs less but is never as effective as face-to-face training. Choose on-site setting, even if it means spending extra money. Also, insist on having an expert on-site during go-live.

6. Not insisting on formal training material or not using desktop recording software to record the training session

Insist that the vendor provide formal training materials that can be used to train new staff. Ideally, the training materials will be tailored to your practice requirements. If no formal training material is available, have your staff capture snapshots and create a training binder for future reference. Better still, use a desktop recording software to record the video and audio (if possible).

7. Assuming that the training provided by EMR vendor will encompass all elements that are relevant to your medical practice.

Most of the time, the EMR Vendor may adopt a ‘one size fits all' approach as far as EMR training is concerned. It is in your interest to work with the vendor in designing the training sessions customized to your specific requirements. You may find that some portions are not covered at all while some easy functionality hogs valuable training time.

8. Not validating the credentials of the trainer provided by the EMR vendor in the medical specialty of your Clinic.

We recommend confirming the trainer's credentials before he/she comes on-site. It's very important that the trainer understand the unique requirements of your medical specialty, so the trainer can offer relevant tips to help your staff optimize their use of the EMR system.

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We would like to keep revising this list for the benefit of our future readers. Hence if you believe that there are other training sins that you want included on this list, please do leave your comments. We will have an updated list avaialble for free download soon.

Check out our downloadable spreadsheet on EMR Implementation Costs - an organized approach for getting a good EMR RFP or price quote and select the right-fit EMR Software for you Practice. Don't forget to contact us for a no-obligation 'Free' Selection consulting available to all bonafide buyers.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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1. Not taking the staff into confidence before starting the EMR selection process.

Your staff will be most impacted by the changes in your clinical environment. Hence it is imperative that you help remove the fear of the unknown from the mind of your staff by explaining how implementation of the selected EHR Software will make them more efficient and effective in their day to day operations.

2. Not drawing up the criteria for your decision making process that is objective with a measurable metric rather than basing it on gut feeling.

Criteria should be appropriately grouped and weighted so that you can arrive at a weighted score for each EMR being evaluated. If you are evaluating three or four EMRs and do not have the criteria well defined, chances are huge that some irrelevant issues will cloud your vision and impact your decision making.

3. Not following through with the references or not doing a thorough job with the references.

You may often believe that all references are going to speak highly about the EMR since they have been handpicked by the vendors. However, as we all know, physicians are a closely knit community and it is not difficult for you to validate or repudiate what the references told you about their experience with the EMR Software or Vendor.

4. Accepting at face value what EMR vendors tell you about all their EMR Software features and functionality.

For example, we have found some of the key differentiators claimed by some vendors had actually been decommissioned because they did not work as intended and were back to the drawing board for a re-work.

5. Assuming that larger and well known EMR vendors will be technology-wise more advanced, and customer-support-wise friendlier to your individual needs and situation.

This assumption could be quite misplaced because bigger is not always better as many of these vendors are too busy working on tying up bigger alliances with hospitals and IPAs trying to rope in hundreds of providers in one scoop. Thus, ramping up customer support for small practices almost always takes a back seat and therefore you may be left out in the cold when you need help right away. Larger vendors are less likely to hear you out in regards to your individual needs and even more importantly, make changes to the software to meet your genuine requirements.

6. Selecting a vendor who says that their EMR Software does not need much training and it is easy to pick up.

If you and your staff do not get adequate training, you will not be able to utilize the software to its full extent. There are no plug and play systems that can be implemented in a few minutes, few days, or even few weeks. Negligible amount of training built as part of initial implementation proposal is nothing more than a contrived method to win your business.

7. Being too focused on price early-on in your search or believing that there really is such a thing as Free EMR Software rather than focusing first on what you need for optimizing your clinical processes and workflow.

A lowest cost approach does not typically translate into saving a lot of money and a lower Total Cost of Ownership. Once you determine what you want and need, you may start drilling down into pricing the EMR Software alternatives you are considering. Don't get pushed into making a decision, be patient.

8. Selecting an EMR on the basis of current requirements alone and not considering your foreseeable or possible future needs.

Growth is generally inevitable and you may take on new providers (multi-specialty?), offer new services, or use devices that need to interface with the EMR.

9. Believing that you or an appointed member of your practice has all the time, knowledge, and experience to handle almost a monumental responsibility for undertaking the research, screening, selection, negotiating, and implementation of the best suited EMR Software for your practice without guidance from an experienced EMR consultant. There are too many decisions to be made and if you stop and think about it, you may realize that you truly do not know all about the good, the bad and the ugly, about EMR selection, implementation, price negotiation, hardware selection and more. Engage with an EMR Consulting company to assist and work with you.

10. Not having a true picture of how the EMR will help create a true paperless office and what components will or will not be addressed by the vendor directly as part of implementation.

You must ask the EMR vendor to adequately demonstrate that their EMR Software will in fact increase efficiency and translate into increased revenues.

11. Not taking enough time to discover and evaluate the initial and recurring costs of implementing EMR.

This also includes understanding the technology underpinnings required to support the selected EMR. It would also greatly help if you define and require the line items expected on the proposal from every EMR vendor you are considering so that you can make the best apples to apples comparison between different EMR Software.

12. Not clearly understanding what the vendors always mean by that or this is included at no additional charge.

A good example of this is not clearly defining what they mean by a bi-directional interface with labs. There are actually two costs involved in setting this up and usually EMR Vendors mean that their side of the cost is included and that they can accommodate the connection but, someone (you) will have to pay for the other side of the connection.

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We would like to keep revising this list for the benefit of our future readers. Hence if you believe that there are other blunders made often by Physicians in EMR selection process, please do leave your comments. We will have an updated list avaialble for free download soon.

Learn about the top 10 EMR Software features that you should be looking for. Download our free article on Top 10 Electronic Medical Records features for every physician.

RevenueXL can not only help you select the right EMR Software, but also guide you in implementing your chosen EMR Software a.k.a. EHR Software.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.