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Choosing an EHR

Choosing the right EHR is dependant on a variety of factors, including practice goals, office size, technological capabilities and expertise, and cost, among others. By carefully considering practice needs in the selection process, practices can maximize the benefits of an EHR.

* Special note on certification: The ACC highly encourages members to choose an EHR certified by the Certification Commission for Healthcare Information Technology (CCHIT). CCHIT has developed a set of testing criteria for ambulatory EHRs that focus on the functionality desired for the primary setting. The testing criteria include functionality, security and interoperability measures. The benefit of a CCHIT-certified system is that you know the application will meet certain standards.

Below are additional questions to consider when deciding which EHR vendor to choose:

1. Does the EHR allow you to meet your goals for adopting an EHR? Check to make sure the EHR you ultimately select will be able to meet the goals you set prior to meeting with vendors.

2. Have other cardiovascular practices used the EHR you are considering? Given the cardiology-specific metrics that need to be recorded, it’s important that any EHR you choose be able to meet these needs. This can be achieved by buying software that comes with some cardiology-specific modules, or by customizing the EHR’s templates to suit your needs. Also, practices should ask other practices that use the software about their experiences. Check the company’s references!

3. How easy is it to customize the software? No matter what software you buy, some degree of customization will almost certainly be necessary. Customization will allow you to change the templates to ask for normalized data rather than text, cardiology-specific data or data important only to the practice.

4. Does the software have the ability to interface with local laboratories and hospitals? To decrease the amount of time spent duplicating order forms and other paperwork, practices should look for software that can interface with the labs and hospitals that they most often use. If an EHR cannot be found that interfaces with all, practices should consider purchasing separate interfaces to make the interconnectivity possible.

5. Does the software work with your technology infrastructure? Think about how the requirements of the EHR software fit with your current and future technological capabilities. For example, many practices with remote offices opt to use a “thin-client environment,” where the EHR is loaded onto a central server, which can be accessed from any computer by logging on to the server. Practices can then choose whether to install computers in every room, or use laptops or tablets.

6. Is the EHR an application service provider (ASP)? Unless you have very specific needs, choosing a vendor with an EHR as an ASP is easiest. The ASP vendor hosts the servers, maintains the software and takes care of all the IT issues that occur with the operation of a large software application.

7. What will be the total cost of the EHR? The cost of the EHR software alone is not the only cost to consider when choosing an EHR. Just as important are the installation costs – including hardware, training, implementation and consulting – and maintenance and support. In addition, some practices have reported experiencing a loss of productivity for a few months while staff adjust to using the EHR system. For more considerations, visit the Contract Negotiations section.

A PDF of this document also is available. For information on EHR consultants that are participating in the ACC's EHR Selection Initiative, click here.