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Need advice on buying EHR software? Here's whom to ask

Don't invest in EHR software without seeking input from peers, affiliated hospitals, local information exchanges and above all, employees. Here's what to ask and what to expect.

Previously our buyer's guide looked at Web-based electronic health record (EHR) software as an alternative for small providers. In this section, providers will learn whom to ask for advice as they continue to narrow their list of potential vendors.

Though it is critical to get feedback from employees, there are groups of people and organizations outside a provider's walls that may affect the decision as well.

Peers. What are similarly sized practices in your specialty using as their electronic health record  software? Call the ones you know. Find out what they've bought and ask them what they like and don't like about how the software works.

Local hospitals. You'll be exchanging patient data with them, so find out which system they're using, and make sure the ones you are considering are compatible with theirs. In theory, all EHR systems soon should "speak the same language", but better safe than sorry.

Affiliated hospitals. Are you an ambulatory physician affiliated with a local hospital? Ask if it's offering an incentive to adopt a preferred EHR software system. If so, put that system on your short list. Even if no incentives are available, make sure the systems you are considering are compatible with the hospital's.

You'll have to deal with vendors eventually. Don't be afraid to ask them tough questions.

Local, state and regional health information groups. Many health information exchanges (HIEs) and regional health information organizations (RHIOs), such as the New York Clinical Information Exchange (NYCLIX), predate the Health Information Technology for Economic and Clinical Health, or HITECH Act, which itself created HIEs for each state, the District of Columbia and five federally administered territories. All have interfaces with local providers. Some even have a lot of experience assisting providers in setting up their electronic health record software. They also know which software outputs the cleanest, exchange-ready data, and which applications cause the most headaches. Finally, they can survey the landscape to understand what their connected providers use for EHR software; and they can tell you which systems are preferred locally, and why.

Regional extension centers (REC). These federally funded health IT tech-help agencies will vary in their missions and capabilities. In general, discuss with your local REC which EHR software it recommends for providers your size, and why. Then find out whether the REC provides EHR implementation services -- and whether that varies depending on which EHR software you choose.

Employees. Put together an office task force that includes at least one representative from each group that will use the EHR software -- physicians, nurses, front office staff -- and from other groups as well (radiologists, respiratory therapists, physician assistants and so forth). Gather their input about which software will work best and about improving workflow and accuracy.

EHR vendors. You'll have to deal with vendors eventually. Don't be afraid to ask them tough questions. Meaningful use will be rolled out in stages, so ask about their strategies for compliance with each stage. Be wary of meaningful use guarantees from EHR vendors; the only "guarantee" that matters is official certification from an accredited organization. Before signing on anyone's dotted line, get some customer references, preferably from providers the same size and in the same specialty as you, and speak to them. Finally, make sure the company can stand up to market forces; the last thing you want is legacy EHR software from a vendor that no longer exists.

Ultimately, no one can tell you which EHR software to buy. Numerous factors, ranging from usability to interoperability to cost, are going to influence your decision. Nor is it a decision to be taken lightly; every department in your organization that will use the system needs to be involved in the selection process.

Above all, do not settle. If there is a particular feature that your organization absolutely needs, and an EHR vendor either does not support it now or does not intend to support it in the future, do not select that vendor. Given the sheer multitude of vendors on the market, you should be able to find one that provides exactly what you need.

The final section of our buyers guide gives providers strategies for implementing EHR software and making sure they qualify for federal meaningful use incentives.

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