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Meaningful Health Care Informatics Blog

Mar 25 2013   9:12PM GMT

When choosing an EHR, consider all options



Posted by: RedaChouffani
cloud EHR, EHR, EHR systems, Electronic health records, ONC, SaaS

Since the enactment of ARRA and the stimulus package, which offered financial incentives for the implementation of electronic health records (EHRs) for eligible physicians and hospitals, the adoption rate of EHRs has increased significantly.  According to a report by the ONC in December 2012, since 2009 and as of 2012, two-thirds of physicians surveyed have adopted computerized capabilities such as electronic medication lists and drug interactions.

Yet among others that fluctuate, one challenge remains the same for physicians, and that is the process of selecting an EHR solution to help achieve meaningful use.  There are several critical steps that must be taken in consideration as part of this careful selection process. Some  include:

  • Performing a practice readiness assessment
  • Reviewing the plan and GAP analysis
  • Reviewing and performing an EHR comparative analysis to review functionality, compliance and return on investment
  • Implementing the EHR solution of choice
  • Post-implementation reviewing and optimization

However, part of this process includes stages that have long-term organizational consequences.  One of those stages is defining which EHR implementation model should be selected.  There are currently several implementation paths organizations can take:

  • Software as a Service(SaaS)/Cloud based EHR: Leverages vendor-hosted EHR systems available via Citrix or terminal services to the workstations, eliminates the need for a significant capital investment on the hardware infrastructure within the facility, also has option of cloud and web based EHR systems that provide the application via standard internet browsers.
  • Outsourced billing with on premise EHR: commonly offered by billing providers and revenue cycle management groups, enables the practice to go on an EHR system but outsource all their billing roles and activities.
  • On-premise EHR implementation: common choice, requires significant investments up front but  provides improved performance, may require more support and maintenance of backups, disaster recovery planning and other internal IT functions.
  • Hospital hosted implementation with add value services:  A fourth model has been available around large health systems and that is the IDNs offering EHR to the surrounding independent physicians.  By offering the same EHR system that is being used within the hospital physicians are able to get the benefit of gaining immediate access to relevant hospital data for their patients, which traditionally would have required interfaces and connectivity to HIEs.

The selection process of an EHR system can be intimidating at first.  ONC offers many useful resources. Third-party consultants can also provide valuable assistance.

On the whole, a successful selection can mean a successful implementation, not to mention improved care, safety and workflow.

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