Fearless EMR Selection

So you’ve finally decided to implement an electronic medical record. You’re understandably nervous. It’s frightening to spend so much money and even scarier to consider the potential disruption to your income that may occur. So how do you decide which system to buy?

Narrow the focus of your search, using some easily accessed online resources:

• Buy a product that is certified by Certification Commission for Health Information Technology. CCHIT is a government task force established to set standards for EMR products. Its goal is to allow systems to communicate with each other and enable more interfaces in the future.

• The American Academy of Family Physicians’ Center for Health Information Technology and the American College of Physicians both have tools to help member physicians decide on an EMR. Your own specialty society may, too.

• DOQ-IT, a federal program administered through state quality improvement organizations, helps primary-care practices choose and adopt an EMR.

• Several professional IT organizations have programs to improve EMR adoption, including HIMSS and TEPR.

Next, compare products in terms of:

• Implementation process -- I can’t emphasize enough that this is the most important factor predicting success or failure of EMR adoption. It is essential to know how the vendor plans to move your office from paper to electronic records.

• Cost -- You know the cliché: You get what you pay for. Our office ultimately decided on a fairly pricey system; it has become quite profitable. In general, the cheaper systems offer less functionality. Include at least one higher-cost system in your search for comparison’s sake, so you can see what you’d be missing.

• Disease management -- With performance-based payment emerging as a trend, select a system that’s smart about maximizing quality. EMR is more than a note-generating tool; its database of patient records can -- and should -- be used to maximize quality and eventually reimbursement.

• E-prescribing -- This is a “must have” part of any system.Why? Because starting in 2009, all physicians who e-prescribe will be paid more by Medicare.

• Online communication tools -- Does the system allow you to communicate results to your patients via e-mail? Does it allow for “e-visits?” Insurance companies are paying for these more and more.

• Good future -- We purchased our EMR in 1996. Most of the products sold at that time are no longer in existence. Check out a vendor to make sure it’s solid and moving forward.

Finally, make a site visit. Never buy a system that you have not seen functioning well in person at an office that is comparable to yours. If the EMR vendor can’t show you an actual practice using its product, then don’t buy it. Salespeople can make any product look good; only by visiting another medical practice will you see both the good and the not-so-good.

Robert Lamberts, MD, is a board-certified primary care physician with Evans Medical Group in Evans, Ga. He serves on multiple committees at several national organizations for the promotion of computerized health records, for which he is a recognized national speaker. He also maintains a popular, more-or-less healthcare-focused blog, distractible.org. Dr. Lamberts can be reached at rlamberts@EvansMedicalGroup.com.