Top considerations when selecting an EHR vendor

Practice needs

EHRs are not one-size-fits-all, so understanding necessary functionality at the forefront is essential to narrowing down vendors in the EHR selection process.

A practice might seek an EHR that provides features such as the following:

• Patient portal integration.
• Advanced analytics.
• Integrated revenue cycle management.
• Medical imaging integration.
• Telehealth tools.
• Population health features.
• EPrescribing tools.
• Health information exchange integrations.

Additionally, certain EHR vendors offer products with specialty-specific workflows, including pediatrics, behavioral health, women's health and urgent care.

Market scan

Once a practice is clear on its EHR functionality musts, a market scan to identify all viable products is a practical next step.

An AMA toolkit suggests that organizations use industry reports from KLAS and Gartner, as well as recent news, to summarize EHR features, market share and budget considerations.

For instance, the annual Best in KLAS report assesses EHR vendor satisfaction using information from more than 26,000 evaluations representing the opinions of healthcare professionals from over 5,000 healthcare organizations.

Additionally, the ONC Certified Health IT Product List provides a comprehensive and authoritative resource of all health IT modules that have been successfully tested and certified by the ONC Health IT Certification Program to meet the HHS functionality and security requirements.

Using the resource, stakeholders can compare specific EHR systems' features.

Further, stakeholders can reach out to organizations similar in size and specialty to investigate their EHR selection processes.

A 2022 study outlines how an academic medical center conducted market research using internal materials from leading medical centers' EHR selection and implementation initiatives. The research involved hours of internal interviews with subject matter experts to identify the pros and cons of each product.

Once a practice has completed market research, the study suggests stakeholders create a summary report outlining each EHR's functionality, market share, financial condition, top 10 clients, and vendor pros and cons.

Total cost of ownership

As the industry faces financial pressures and workforce shortages, determining the total cost of ownership is a critical step in EHR purchasing decisions.

Generally, there are two kinds of EHRs, each with different cost models.

On-premises EHRs are hosted locally and managed within healthcare facilities. These platforms often require high initial hardware and software costs. The benefits of these systems include the ability to operate offline because the technology is hosted on local servers. The platforms might also offer practices with more customization options.

However, healthcare organizations must be aware of ongoing maintenance and support expenditures for on-premises platforms, which add to the total cost of ownership. Practices that use on-premises EHRs must hire on-site health IT staff to maintain and oversee hardware and software, including regular updates, security and troubleshooting.

Additionally, scaling on-premises EHR systems to additional locations or users involves adding more servers and infrastructure, which can be costly.

Cloud-based EHRs are growing in popularity due to their cost-effectiveness. The systems eliminate the need for significant upfront hardware and infrastructure expenditures. Instead, healthcare practices pay a monthly subscription fee. Some cloud EHRs allow users to pay a monthly fee as low as $100.

Cloud-based systems also eliminate the need to invest in ongoing support services and upgrades, as these are often included in EHR subscription fees. Additionally, cloud-based EHRs allow healthcare organizations to easily expand or contract their health IT infrastructure based on changing needs.

Vendor selection site visits

After an organization has narrowed its list of potential EHR vendors to a few choices, stakeholders should set up vendor selection site visits for each option, according to ONC.

Site visits can help practices learn more about their possible EHR choices and gather lessons learned from peer organizations.

To set up site visits, stakeholders can ask potential EHR vendors for lists of providers who have successfully implemented their EHR offerings. Then, organizations can contact these practices to schedule times to visit.

ONC recommended that stakeholders try to find organizations like theirs in terms of specialty, geographic location and size to make site visits more productive.

Additionally, ONC noted that carefully selecting a site visit team is critical. The group should include someone from each department and the EHR implementation team leader.

"Pair up manager with manager and physician with physician so your site visit team can ask detailed workflow questions specific to your organization's specialty, geographic location, and size," ONC suggested.

Healthcare organizations should exchange contact information with each site in case follow-up questions arise. Then, organizations schedule an internal debriefing session to discuss visit findings.

Selecting the right EHR vendor is a significant decision with long-term impacts. By thoroughly understanding practice needs, conducting a detailed market scan, evaluating the total cost of ownership and completing vendor selection site visits, organizations can make an informed choice that aligns with their digital health needs today and in the future.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.