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  • Luis Montes

9 Key Factors to Consider when Selecting a New EHR System


Electronic Health Records (EHR) have become a commonplace in today’s healthcare organization where a care provider interacts with an EHR to manage various clinical and business functions. With the level of complexity continuously evolving, EHR’s are no longer simple static patient “Health Records” but rather an ecosystem of applications touching every aspect in a healthcare organization.


For these reasons, selecting a right EHR partner is a key strategic decision affecting business along various key performance indicators (KPI’s). Wrong EHR decisions can lead to a variety of problems such as reductions in overall patient experience, delayed time to admission and care transitions, reduction in staff productivity and cash flow, reduced referral flow and even staff turnover to name just a few. Let us look at a list of business drivers to help you ask the right set of questions when considering an EHR system and measuring their business performance. This is not meant to be an exhaustive list but rather a starting point for evaluating your organizational needs and EHR partner fit.


1.Strategy and Business Goals: This may seem obvious, but I am putting this at the top of the list because it is often overlooked when implementing an EHR system. A right EHR partner should be able to scale with your organization to help not only support but evaluate your business goals and strategy. In this case it is imperative that the executive team gets involved in strategy planning early on with the right set of questions.

For example, what is your growth target over the next 3 years? Can your EHR system support your aggressive expansion plans? Does it have a track record of success with enterprise level customers? Can it help you scale into net-new verticals such as home healthcare, outpatient therapy, skilled nursing, acute care, etc.?


2. Security: In the age of cyber-crime and malware attacks on patient records it is crucial for a health organization to partner with an EHR vendor who has well defined security protocols and architectures in place to protect your business. Make sure that your IT team has the right set of training and information controls in place ensuring compliance with organizational and regulatory standards.

An EHR vendor should be able to provide penetration tests on their various applications, SOC-level audits and well documented accreditations for HIPAA compliance standards and breach trace records to help prevent future attacks.


3. Patient records, clinical documentation, patient scheduling and billing. While these are basics, they form the ‘essential gut’ of an EHR system and should be evaluated for each end user type, such as, administrative, compliance, billing and clinical, to ensure that the system can meet all of your business needs. This further helps differentiate EHR vendors with strong administrative and billing modules against those with poor documentation systems known to cause clinical frustration and staff turnover.

Admin tools with proper scheduling and patient filing can add tremendous efficiencies to the back office when handling billing functions that can make or break your business cash flow. When evaluating billing modules, an EHR system with a robust and integrated clearing house partner becomes key to processing insurance claims and patient payments timely.


4. Interoperability: How good is your EHR at talking to other EHR systems up or down the continuum of care? Interoperability is a critical component of patient experience particularly during transition of care and clinicians need to have the right information at the right time for better patient outcomes. This has become an important component of the federal government strategy through the ONC’s Cures Act Final Rule & the Promoting Interoperability initiative, an initiative designed to restrict the patient health information blocking between health systems.

An EHR system with a good interoperability strategy can help your organizations better align with other systems exchanging PHI electronically and support the growing list of physicians who would rather e-refer patients directly from their own EHR systems without relying on legacy methods like fax.


5. Regulatory Compliance: Does your EHR system have the regulatory logic built in to help run your organization compliantly? Is your compliance officer aware of all the steps involved in the vetting process? Depending on your clinical care setting, your EHR must meet the specific compliance requirements specific to your care segment.

With healthcare rules constantly changing across acute and post-acute care, your EHR system must stay current with regulatory changes such as PDPM, PDGM, MIPS, etc. and keep up with ICD-10 code updates, fee schedules and CCI edits.


6. Business Intelligence / Analytics: In the past couple of decades, EHR systems have evolved from being data repositories to having varying degrees of reporting and analytics built into them. Your data and health records are a powerful predictor of business and clinical outcomes and it is essential that your EHR system supports business, clinical and compliance insights aligned with your organizational success. Leveraging data bypassing 3rd party aggregators has become a key business enabler and EHR systems have made investments in building integrated Business Intelligence capabilities to ensure timely insights could be generated and acted upon.

Your vendor needs to have the right BI toolset generating insights relevant to your operations. Ask your vendor about their data strategy roadmaps and adoption of modern technology such as Artificial Intelligence (AI). Do they have industry benchmarking tools? Does your EHR partner take data science & analytics seriously?


7. Peripherals – practice management (PM) and patient engagement (PE) tools: PM and PE technology choices and the resultant patient experience scores could mean the difference between thriving and declining business. How are your peripherals improving operations and more importantly the relationship with your patients outside of the clinic?

EHR systems with workflow optimization capabilities such as document tracking, payor eligibility checks, physician signature solutions and payment tools can reduce your labor costs by as much as 50%. Some of the emerging EHR systems also offer PE tools such as telemedicine, remote patient monitoring (RPM) appointment reminders, medication dosage management and personalized home exercise programs. Having an EHR system with a robust set of built-in PE tools (or a tightly integrated peripheral ecosystem through third party vendors) can lead to improvements in patient experience and net promoter scores (NPS), clinical outcomes and patient readmissions rates.


8. Service and Support: Having the right set of SLAs supporting your business metrics are essential in maintaining high NPS among your EHR system users. Are your average ticket response times satisfactory? What is their average Time to Resolve? What is their method of communications with clients (call, email, community portal)? If you are a large/enterprise level organization, it is important to engage your IT department to ensure your EHR vendor can render SLAs supporting your organization.


9. ROI: While price is an essential determinant to your ROI, it would be a mistake to select an EHR vendor solely based on price. A low priced system could lead to higher inefficiencies within your operations leading to significantly higher TCO, while a higher priced system could potentially reduce your total cost of ownership (TCO) and have a high impact on your business KPIs and patient satisfaction scores.


For example, clients that have optimal EHR implementation systems in the outpatient therapy space can improve their net income per visit and net total revenue per clinician while improving the overall experience of both the clinician and patient.


Thus, it is important to factor in financial impacts of inefficient billing modules or poor clinical documentation systems affecting clinician turnovers. Systems generating inaccurate insights from misaligned sets of analytical workflows can lead to critical business misinformation or costly security breaches. Thus, having a well-founded and articulate way of measuring your organization’s KPI and ensuring that your EHR can enable them is a much better way to analyze your decision.

While there are more factors to consider, our more than two decades of collective experience has taught us to remain curious and to keep learning. We would love to hear about your business challenges and explore ways to help measure your performance across our researched set of KPIs and performance metrics.


Please feel free to contact us if you are considering implementing a new EHR system for your organization. Also, let me know what other factors you consider valuable within your EHR system in the comments below.

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