Posted By Ashok Mathur On September 22, 2014
With the federal mandate of using an Electronic Health Record (EHR), local health departments are diving in selecting an appropriate EHR. The fact that local health departments are way behind with EHR adoption compared to other medical practices, the situation is more urgent. Only 22% of local health departments have some sort of an EHR while over 40% of other medical practices have an EHR. Additionally, with budget cuts, local health department leaders know they can gain tremendous needed efficiencies with an EHR software. So, how do you go about selecting an EHR for local health departments?
Here are 7 important steps (and a bonus step) for the EHR selection process:
1. Identify major goals: Write down key goals and objectives of getting a new EHR. This can be a simple list of 3 to 5 major items. For example:
- Comply with federal meaningful use
- Increase revenue by having an efficient billing software (it is common to get 15% to 20% increase in revenue)
- Increase efficiency via automation (e.g. by reducing double data entry)
- Easy to get reports and accurate data
- Avoid staff frustration with current mish-mash of paper and electronic system.
2. Form a Selection Committee: No one person knows all the answers or questions. Form a small committee (2-4 but no more than 7) comprising of various experts from patient administrative, clinical, IT and finance.
3. Write down high level requirements: Write down, in brief, your major requirements. Do not make it complicated, just write down a bullet list. You should be able to capture these in 1 to 2 pages. Keep in mind federal meaningful use (MU) certification ensures that an EHR meets lots of requirements. Instead of restating what is in MU, focus on your unique requirements. For example, if you are a local health department, you will wish to focus on reporting (state/federal), compliance (programs) and population health.
4. Short List EHR vendors: Initially you may wish to cast the net wide; maybe 7 to 12 EHR vendors. This list may include vendors who specialize in your market segment (e.g. public health) or general purpose vendors. Research these vendors (the internet is your friend), check with other agencies, talk to these vendors, and get a list of customers similar to you to see if the vendor would be a good fit for you. Narrow the list and invite 3 vendors for a demo.
5. Score various EHR: Get a large team of users to attend the demo; approximately 10-20 people representing various functions. Make sure people who actually use the system (not just supervisors) participate in the demo. Develop a scoring system for each function in your organization. Get users to rate each vendor’s product (e.g. a score of 1 for low and a score of 5 for high).
6. Compare prices: This is not as simple as one might think. Each vendor quotes differently. Ensure that the vendor includes price for upcoming (needed) upgrades like meaningful use stage 2, stage 3, ICD 10 and CPT updates. Some companies will skimp on training to keep initial price low. There may be additional per transaction charges (e.g. for billing, insurance eligibility). Make sure you are comparing apples to apples. This is difficult.
7. Check References: You want to make sure that the EHR performs well in practices similar to yours. For example, if you are a local health department then make sure you get more than ten references of the EHR being used by local health departments. (By the way, you know local health department’s needs are different than that of community health centers). Do not settle for less than ten references. In fact, you should ask for a complete list of all local health departments where the software is being used. You pick and choose who you follow up with.
+1 Bonus Step: No matter what, make sure that the EHR is easy-to-use. Sure, IT folks and some staff are computer savvy and can use any software system, but, you must purchase an EHR which can be used by less computer savvy staff as well. If the EHR is not easy-to-use, it may become an expensive white elephant with marginal return on investment. Alas, we have seen too many software systems which do not get used as selection process did not emphasize this bonus point.
In each of the above 7 steps, you need to make sure you emphasize ease-of-use. So one of your major goals in step 1 has be “easy-to-use and easy-to-learn EHR”. Make this mantra of the EHR selection committee.