Ask Joy: This Week – Ask the Tough Questions
This week, let’s talk about the key questions you can ask a vendor the next time you’re in the market to purchase, upgrade, or switch EHRs. This topic was covered very eloquently by Shahid N. Shaw, aka The Healthcare IT Guy, in last week’s Learning Lunch, titled, “Top 10 Questions to Ask An EHR Vendor During a Demo.” The questions were good, but the answers were better. Here’s a sample of the topics covered and a summary of why each is important.
Ask: How can I be sure the EHR can be customized to fit my practice?
Purchasing the right EHR for your practice is one of the most important decisions you’ll make. It will greatly impact the daily flow of information, patients, and tasks through your office. While most EHR companies claim to be customizable, the workflow is often hard-wired into the EHR, based on specific decisions that have been made by the vendor. While the system may be a perfect fit for the providers who advised them on the design in the first place, it may not be a perfect fit for you. Remember, a vendor will never understand your practice as well as you do.
If your practice is new to EHRs, you may want to buy a system that has minimal workflow built in so you can customize it to reflect your specific needs.
If you’re replacing a system you’ll want to see if the new system matches the electronic workflow you’re accustomed to now. If there’s something you hate about your current system, make sure you take notes and talk about those with the new EHR vendor. Prepare for the demo by understanding where technology has failed you in the past, so you can provide quality feedback about what you want.
Ask: Are there multiple ways to take notes within the EHR?
Understandably, not all providers are ready or willing to take the plunge into the deep end of the EHR pool. Some are more comfortable stepping in one foot at a time. For this reason, many EHRs offer a variety of input styles. So, if you have a technology-resistant provider or multiple providers with different styles of taking notes, ask if the EHR can accept scanned documents, dictation, faxes, transcription, typing with a keyboard, etc. The more flexible the EHR is with accepting information into the system, the more likely you are to get the technophobes on board.
Ask: How does the EHR receive and file faxes?
Though everyone is making an effort to go paperless, the reality is that faxing, especially digital faxing, is still widely used in medical offices. Even if the EHR vendor says that fax is supported, make sure to ask how they are filed and archived, so you have a clear understanding of how to find them later. You’ll want an easy workflow for faxes, and you’ll want to know how to handle spam faxes. The last thing you want is a spam fax to become part of a patient record.
Ask: What additional costs can I expect to pay down the road?
It’s not just software you’re purchasing. After your practice is fully electronic, there will be a variety of new requirements to stay up to date. With every computer there will be additional networking, patching, back-ups, security and upgrades to keep up with. And protecting it all is ever-important, considering the penalties associated with the HIPAA Omnibus Rule. One way to aid with this is to ask your IT team to help figure out the total cost of ownership (TCO) of all the hardware and software associated with the EHR. Part of the reason why cloud-based systems are gaining popularity is their significant reduction on TCO, since the software is not installed on your servers or maintained on your in-house computers.
Ask: Can my billing service access the EHR, and if so, can we limit what they can view?
You’ll want an EHR that will allow your billing company to either remotely access the EHR or have their own secure, role-based login credentials, limiting their view to only what’s necessary to perform their job. Equally important is to find out how many users can view a patient record simultaneously. If possible, include your billing company in the selection process, to ensure that their questions and concerns are addressed. And, lastly, make sure there is no additional cost for more users.
Ask: What EHR training is provided, and how long will it take for users to be up and running?
First of all, the EHR demo is a great opportunity to get a feel for the system. Ask to be the “driver” during the demo and find out how the EHR handles the specific needs of your own workflow. The best EHR systems will feel natural and require very little training. However, for the training that is provided, make sure to train on the specific screens you’ll spend the most time in and try to understand the functions you’ll be relying on most. Vendors are somewhat notorious for providing extensive training to first-time users, and then tapering off as they get new clients. Picking a train-the-trainer model is one way to be proactive about that problem.
Ask: Can I easily search for patients by medication, diagnosis or procedure?
While this functionality is usually built in to the EHR in order to be certified for Meaningful Use, some vendors handle this better than others. Choose a vendor that lets you save your common searches and lets you run them routinely and quickly. Think about what you’ll be using the results of these searches for—will the list be sent off to a part-time worker to contact patients of a certain age, with a specific problem or lab result to schedule an appointment on a weekly or monthly basis? What type of workflow flexibility will the report functionality of the EHR provide?
For more information on this topic, go listen to Shahid N. Shaw present this Learning Lunch. You won’t regret it.
About the Author: Joy Rios has worked directly with multiple EHRs to develop training programs for both trainers and practice staff. She has successfully attested to Meaningful Use for multiple ambulatory practices in both Medicare and Medicaid. She also authored the Certified Professional Meaningful Use course for www.4Medapproved.com. Joy holds an MBA with a focus in sustainability. She is Health IT certified with a specialty in Workflow Redesign, holds HIPAA security certification, and is a great resource for information regarding government incentive programs.Ask Joy is a regular column on 4Medapproved HIT Answers.