Behind the EMR Rankings

Are you in the process of selecting an electronic medical record (EMR)? Have you walked the flashy exhibit hall aisles or clicked through some cool demos? And have the products already started to become a blur in your mind? 

It doesn't take long before most physicians shopping for an EMR feel desperate for help.

Selection guides -- Consumer Reports-like resources -- are out there. Some are free, some are as little as $19.95, or you can spend thousands of dollars.

All can be good screening tools, but don't rely on any single one of them. It is helpful to look "behind the scenes" of these reports and services to understand their data sources and limitations. Here are few examples:

The Digital Physicianwww.digitalphysican.com
Digital Physician provides online comparisons of about 70 EMR products. Since there are hundreds of EMRs available, starting with a database of just 70 already probably oversimplifies your search. The guide reports on 30 features, as well as company information including contact, years in business, number of users, and HIPAA compliance. Sometimes you also can compare product prices.

Be forewarned that some of the information is dated -- up to two years old -- and the report offers just limited information about EMR product features. However, as one of the least-expensive resources at $19.95, and with a money-back satisfaction guarantee, The Digital Physician can be a good point of entry. Just don't use it exclusively as it may narrow your selection prematurely in your process.

Jewson Enterpriseswww.jewsonenterprises.com
The POMIS Report from Jewson Enterprises (POMIS stands for "physician's office management and medical information systems") includes practice management and EMR system vendors. It contains facts, figures, and insights from multiple sources, analyzed by the author, Vinson J. Hudson.

The report provides market forecasts, demographics, and analyses in the context of healthcare events and trends, technology utilization, and competitive performance. It is published in three volumes and available on CD:

• Volume 1: The POMIS Report market research and analysis document,
• Volume 2: The Satisfaction Rating Directory of POMIS Vendors (The SRD), and
• Volume 3: The Ambulatory Care Setting - EMR/EHR Systems Analysis.

Volumes can be purchased individually. All three volumes will cost you thousands of dollars, but the full service does include telephone support (typical reports range from $2,500 to $5,000). Jewson's quarterly newsletter is a cheaper alternative, but its content varies based on recent trends and events in the industry. It's not comprehensive.

If you've had some exposure to EMR products, this rating directory will help you compare and contrast in a systematic method rather than defaulting to your emotional reaction to a vendor demo.

CTS www.ctsguides.com 
This site provides ratings and reviews of software packages and a generic checklist of features you can use to evaluate systems and prioritize against your needs. The information includes product comparison data (pricing, hardware, operating system, support policies, etc.) and written reports on CTS' top picks.

Its software tool, The Requirements Analyst, helps you select a product for your practice. You enter a weight (0-3) for each feature in the checklist indicating its importance to you, and the software tool ranks the CTS top picks (which means the pool of potential products is limited) by the percentage of needs met for your practice. All services are available online.

This tool can be helpful if you have not identified many vendors for your selection process. It is also useful to help you create a needs checklist if you haven't begun to document your needs.

AC Group Inc.
www.acgroup.org
The AC Group offers extensive reports priced from $100 to over $200, but also makes free samples of its reports available online.

The EMR report is based on cumulative results of a 90-page survey with 5,455 questions divided into 27 categories. The EMR/EHR report assigns a weighted point value for each of the questions, which provides another dimension for evaluation.

Although the report provides a lot of information, the survey findings are based on what vendors said about their own products, and some EMR vendors elect not to participate --  the survey's size turns some off. Still, this report is useful to provide a launching point for further dialogue with selected vendors.

EMRConsultant www.emrconsultant.com
This site offers "free consulting services." Someone must be paying for the services, and as a well-informed buyer, you need to ask who. EMRConsultant is a unit of 1450 Inc., which sells speech-recognition software, and drives referrals to vendors, which then pay the company a fee.

This site asks you to complete a very brief questionnaire about your practice needs. Your responses are sent to EMR manufacturers.

The service includes a summary of the features and functions of the recommended EMR products. This information is provided by the manufacturers and sellers. A nice feature of this particular tool is the ability to add your own comments and to maintain those for future reference as you progress through your system evaluations.

ELMR www.elmr-electronic-medical-records-emr.com
There are many healthcare providers who have created Web sites, discussion groups, and now blogs to share their EMR search experience and to learn from others in the same process. This site by Kirk G. Voelker, MD, offers real advantages. If you're a novice, the site offers a primer on EMRs. You'll find useful reference links and a cost calculator that is a worthwhile exercise.

The electronic medical record comparison table identifies approximately 70 electronic medical record systems and nicely indicates the last update for each vendor on the table, so you'll know how current the data is.

Discussion forums are available as well. Unfortunately, you'll typically find more information about what doesn't work in these types of forums than you will find practical tips for enhancing the usability of a product. It's human nature to share bad news more than good experiences. Satisfied users move on to the next phase of implementation, while dissatisfied users need to vent. Take the feedback on all forums with a grain of salt.

The KLAS Reportswww.healthcomputing.com
KLAS' online subscriptions provide subscribers with online access to current (within the past 13 months) vendor performance data as reported by healthcare professionals (CIOs, providers, administrators). The reports include anonymous commentary for insight beyond the survey instrument responses.

KLAS offers both free and expensive versions of reports. A word of caution regarding the comprehensiveness of the "free" data is warranted. According to KLAS, the evaluation takes about 10 minutes to rate 40 key performance areas, which may allow for only cursory responses from the participants. However, the KLAS reports represent over 500 products (300 vendors) and 4,000 facilities (physician practices are included but so are home health, hospitals, radiology centers, pharmacies, and laboratories).

The online Vendor Profile includes a brief vendor overview. Product Tidbits includes a sample commentary from an unidentified healthcare provider, related specialty reports available for purchase, and the standing in the Top 20 Best in KLAS as to each category and an indication of meeting KLAS' minimum standard of confidence levels. The rated products are specified by physician practice size.

You also can buy industry trends data, Top 20 Reports, as well as graphing, ad-hoc reporting, and printing functionality for your own presentation needs. The costs of the reports vary from $4,000 to $10,000, and with the breadth of markets served, the sampling of data pertinent to your needs may be limited.

Using a couple of the ranking tools may be more helpful than relying on just one. Think of it as tuition: Educating your practice about the products and how they compare in the market is a good investment prior to your EMR purchase.

Rosemarie Nelson can be reached at editor@physicianspractice.com. Resources and vendors mentioned in this article were selected as examples by the author, not by Physicians Practice staff.

This article originally appeared in the March 2005 issue of Physicians Practice.