Whether implementing EHR software for the first time or seeking a superior option to your current product, you need to do your homework beforehand. You should create an EHR evaluation checklist to achieve transitional success.

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What This Article Covers

• What Is EHR Software?
• Clinical Features Checklist
• Specialty Practices
• EHR Implementation Checklist
• Common Barriers
• FAQs
• Next Steps

With so many vendors claiming to have a “best-of-breed” solution, narrowing the list of possible candidates can be daunting. That’s why it’s vital to understand your key EHR needs and decide which questions to ask when evaluating and partnering with a vendor.

What Is EHR Software?

Electronic health record (EHR) software is a digital solution that health care organizations use to store digital versions of patients’ files. Besides data collection, they help optimize medical billing, patient scheduling and administrative workflows.

These solutions integrate with HIPAA-compliant videoconferencing software to help you deliver quality care from remote locations and to patients at their homes.

They also integrate with patient check-in kiosk systems to assist you in automating check-in processes.

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Clinical Features Checklist

Every EHR solution should provide physicians with easy access to medical records updated in real time. These solutions offer tools and features to streamline practitioner and administrative workflows.

Below we’ve provided a list of capabilities you should consider while examining products and creating your EHR checklist.

1. Analytics, Dashboards and Reports

Every second counts in the ER. The EHR solution you select should be your ally providing swift access to medical records in real time.

It should also allow you to generate customizable reports for compliance reporting and outcome analyses.

Moreover, envision a system that adapts to your team’s diverse roles like dashboards tailored to the specific needs of physicians, administrators and nurses. It’s not just access; it’s access refined to the pulse of each role, ensuring the right information beats in harmony with their responsibilities.

2. Clinical Charts

Clinical charts are the heart of any EHR system. They should be easy to use and provide a comprehensive view of patients’ medical histories including present illness, clinical histories, social determinants, vitals and measurements, diagnoses, and care plans. This not only ensures legibility but also guarantees accuracy for reliable decision-making.

Ensure the system includes tools for population health management, such as preventive care reminders and chronic disease management tools.

3. Clinical Workflow Management

Seek an EHR solution that enables you to automate routine tasks, prioritize urgent matters and streamline appointment scheduling, order entry and reporting processes. This helps you take a more organized and patient-centered approach to care delivery.

4. Collaboration

Seek EHRs that provide collaboration tools, like secure messaging, task assignments, shared document access, and alerts and notifications, to reduce miscommunications and promote accountability.

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5. Electronic Prescriptions

When selecting an EHR, ensure it provides e-prescribing tools with features like:

• Drug interaction checking
• Dosage and frequency alerts
• Refill requests
• Formulary decision support
• Audit trails

Electronic prescriptions help you improve patient safety, reduce prescription errors and streamline medication management processes.

6. Medical Billing

Medical billing is a critical aspect of health care administration, and it often comes with challenges, particularly in keeping up with frequent coding updates. Recently, the American Medical Association (AMA) released the 2023 CPT code set to help address this challenge.

To avoid coding errors and generate accurate statements, you should look for an EHR system that provides billing and coding capabilities. If you already use medical billing apps, ensure that the EHR integrates with them.

Some other billing and coding capabilities you should consider include:

• CPT and E&M coding
• Claim management
• Electronic remittance advice
• Denial resolution
• Insurance eligibility check
• Copayment tracking
• Taxonomy code and NPI lookups
• Clinical decision support (CDS)
• Clinical care protocols

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7. Mobile EHR

Want to access information on the go? If yes, you should look for a system that offers mobile EHR apps.

They help you track patient progress, approve prescription requests, share educational resources and receive allergy alerts remotely.

Some EHR mobile apps provide offline data synchronization capabilities — store data locally on your device, and once you regain internet access, it synchronizes with the main EHR system.

Mobile EHR liberates you from the confines of a stationary workstation, helping you deliver patient care beyond traditional boundaries.

8. Notes and Templates

Tedious manual entry of patient information and reliance on paper records lead to inefficiencies and challenges in accessing timely and accurate patient data.

You should look for an EHR system that enables you to create, edit and modify SOAP, narrative and procedure notes.

Structured templates and standardized note-taking ensure consistent documentation, making it easier for you to understand and interpret patient records.

9. Patient Engagement

In addition to supporting clinical and administrative functions, EHRs provide patient engagement tools to facilitate communication with patients and improve their overall experience.

Some key patient engagement capabilities include:

• Patient Portal Tools: Enable patients to schedule, reschedule or cancel appointments conveniently through the portal. Allow clients to access their medical records, test results and treatment plans for increased transparency.
• Interactive Care Plans: Create personalized care plans outlining treatment goals, medications and lifestyle recommendations. Allow patients to track and update their progress, promoting active involvement in their care.
• Health Surveys: Collect patient-reported data on symptoms, well-being and treatment effects through surveys or assessments.
• Secure Document Sharing: Enable patients to securely upload relevant documents, such as insurance information or advanced directives for better care coordination.

These features help you boost communication, encourage proactive health management and improve care outcomes.

10. Platform Capabilities

The EHR solution you select should provide capabilities that help you ensure compliance with health care standards and regulations like FIPS 140-2 and HITECH.

Some other capabilities you should consider include:

• Data Encryption: Convert sensitive data into a coded format, preventing unauthorized access and safeguarding patient confidentiality.
• Favorite Lists: Access frequently used procedure codes, pharmacies and prescriptions swiftly, reducing time spent on routine tasks and enhancing overall efficiency.
• Health Information Exchange: Securely share patient information among different health care providers and systems.

11. Telehealth

EHRs providing telehealth tools offer a lifeline to those in remote or underserved areas, ensuring timely access to medical care.

Some key features you should consider include:

• Telemedicine Systems: Perform video consultations from the comfort of your home. Share X-rays, reports and lab results with patients using screen-sharing functionality.
• Wearables Integration: Sync data from wearable devices, enabling continuous monitoring of patient health metrics remotely.
• Virtual Waiting Rooms: Create a virtual space where patients can wait before their telehealth appointments.
• Patient Education Resources: Share educational materials and resources with patients, promoting informed decision-making and self-management.

Check out our article on EHR modules to understand these capabilities in detail.

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Specialty Practices

If you run a specialty practice or clinic, you have the added layer of deciding whether to go with an EHR or medical software for general practices that accommodates multiple specialties or a niche specifically designed for your patient and practice needs.

Selecting the best EHR vendor for your specialty practice entails pinpointing key technical and business considerations such as:

• Specialty-specific features
• Compatibility with existing infrastructure
• Reputation of vendors for tailored customer support
• Scalability to meet evolving practice needs
• Financial considerations

EHR Implementation Checklist

Planning and Preparation

The journey to successful EHR implementation begins with strategic planning and thorough preparation.

Measure Your EHR Readiness

Implementing an EHR isn’t a simple task. It not only requires careful planning, preparation and execution but also a high level of readiness from your organization.

What does readiness mean? It means your organization has the necessary conditions and capabilities to implement an EHR system successfully.

The five main readiness aspects are:

• Culture: Conduct focus group discussions to gauge staff perceptions and concerns regarding the EHR transition. Foster open and transparent communication through regular meetings, newsletters and other channels.
• Leadership: Ensure that financial resources are available to cover software, hardware, training and ongoing support expenses. Communicate long-term benefits such as improved patient care, streamlined processes and data-driven decision-making to motivate and engage staff.
• Operations: Allocate resources efficiently, including staff, time and equipment. Identify infrastructure gaps through an IT audit and upgrade to meet technical requirements.
• Workflow Improvements: Identify inefficiencies and areas for improvement to optimize processes with the introduction of an EHR solution.
• Technology: Confirm that the EHR system seamlessly integrates with existing systems and technologies. Implement encryption, access controls and regular security audits to safeguard sensitive data.

Conduct an EHR readiness assessment to ensure a smoother transition.

Analyze Workflows

Next, analyze current workflows using process mapping or spaghetti diagrams to identify inefficiencies, redundancies and areas for improvement.

Let’s analyze the patient arrival workflow as an example.

• Current Process: Patients fill out paper forms upon arrival, causing delays and potential data entry errors.
• Issues Identified: Inefficiencies in data collection, risk of lost or incomplete forms and delayed initiation of care.

Once you’ve identified the problems, it’s time to plan future workflows — how the new technology will impact roles, responsibilities and communication channels.

Let’s continue with the patient arrival workflow example.

Future Process

• Electronic Check-in: Implement a self-service kiosk or mobile app for patients to electronically check in.
• Automated Data Entry: Integrate the EHR system to automatically capture patient information from the electronic check-in.
• Real-Time Access: Ensure that the electronic forms provide real-time access to patient data for health care providers.

Envisioned Improvements

• Electronic check-in streamlines the registration process, reducing wait times.
• Automated data entry minimizes the risk of errors, ensuring accurate and complete patient information.
• Real-time access to patient data enables health care providers to initiate care promptly, enhancing overall service efficiency.

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Create an EHR Implementation Roadmap

A roadmap provides a clear and structured plan for the entire EHR implementation process. It outlines the stages you need to follow, giving everyone involved a sense of direction.

Some key things to consider while creating a roadmap include:

• Develop a Timeline: Establish realistic timelines for each phase of the implementation. Consider factors like infrastructure upgrades, staff training, data migration and testing. Be prepared for unexpected delays.
• Consider a Phased Approach: Divide the implementation into manageable phases based on departments, functions or geographical locations. This minimizes disruptions to daily operations and allows for focused attention on specific areas.
• Set Milestones: Set SMART milestones:
  • Specific: Define clear objectives for each milestone, such as completing staff training or migrating a specific dataset.
  • Measurable: Establish criteria to measure the successful completion of each milestone. This could include a certain percentage of staff trained or a successful data migration rate.
  • Achievable: Set realistic goals that you can accomplish within the given timeframe and resources.
  • Relevant: Align milestones with the overall goals of the EHR implementation and your organization’s strategic objectives.
  • Time-Bound: Assign specific deadlines for achieving each milestone to stay on track.
• Identify Dependencies: Recognize what tasks you need to complete before initiating a new task for a well-coordinated implementation.

Select the Right EHR

Finding the ideal EHR isn’t an easy task. You can start by identifying your company’s requirements. Check out our clinical features checklist we discussed earlier in this article for the same.

Next, create a shortlist of EHR vendors that best align with your organization’s needs. Evaluate them based on key criteria such as:

• Features: Ensure the system has the necessary clinical features identified during your needs assessment.
• Scalability: Assess whether the EHR can grow with your organization’s future needs.
• Usability: Request demos or trials to evaluate the system’s user interface and overall usability.
• Cost: Consider both initial implementation costs and ongoing maintenance fees.

A mismatch in priorities can happen if the vendor works primarily with companies that are a different size than yours — either smaller or larger — or have limited experience with your specialty.

Once you narrow down your list to the top 2 or 3 vendors at the most, it’s easier to determine which company to trust with your data. Send a request for proposal (RFP) to your top contenders.

RFPs give the vendor the information about your company that they need, such as top EHR/EMR evaluation criteria for the system and your organization’s primary focus.

Once you have vendor responses, invite your top choices to visit your organization. Ask them to demonstrate how their system works and performs.

Look specifically at reviews and surveys. This allows you to eliminate systems with poor reviews or suspect ratings immediately.

We’ve provided a list of questions below that you should consider before deciding which system is best for your physician practice.

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Yourself
Use these questions as a starting point to assess your needs:

• Will the new system have the features we truly need?
• Will the EHR system improve our organization’s workflow?
• How will its design, user interface and functionality increase efficiency and impact patient outcomes and financial performance?
• Do we need a system that can integrate with other platforms like medical billing systems and public health interfaces?

Financial Questions
When you don’t plan your finances, it causes budget overshoots. Use these questions to get an idea about the overall cost:

• What’re the startup and installation costs?
• Are there any fees associated with training?
• What’re the warranty/maintenance options, terms and fees?
• Are upgrades and customer service included as part of the purchase?

Vendor Certification, Security and Interoperability
Check to see if a system is a certified EHR. Proper certifications help reassure providers and patients that products are secure and interoperable with other systems to share information and demonstrate meaningful use.

Here are some questions you can ask vendors about certification, security and interoperability:

• Is your EHR ONC-ATCB certified?
• Is your platform HIPAA-compliant?
• What’s your action plan in case of security breaches?
• Can you guarantee data accessibility?

Support Questions
You must also account for installation, training and support for a new EHR system. Take a look at these questions to start a dialogue around these issues:

• Do you provide data migration assistance?
• Who’ll implement the new system?
• What’re the available training options?
• What support options does the vendor offer when the system does not work as planned or needs upgrades?

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Vendor Credentials and Reputation
You don’t want to sign an agreement with a provider who has a bad reputation in the market. Use these questions to assess the vendor’s reputation:

• How stable is your financial standing, and what assurances can you provide regarding the long-term sustainability of your products or services?
• Can you highlight the diversity of your customer base and your adaptability across industries?
• Have you successfully worked with practices similar in size/industry?
• Could you share customer success stories that align with our needs?

References
You should contact vendors’ references. But don’t completely rely on them. They’re likely to offer the most positive reviews. Ideally, you should reach out to additional contacts for more information and opinions to get a complete picture of your candidates.

Consider asking these questions to references:

• Would you choose the solution again?
• How satisfied are you with your decision to sign a contract with a specific vendor?
• How disruptive was the installation of the new system?
• Did you face any challenges seeking support from the vendor?

Hand out rating forms to employees if you want their input before making a final decision. Do this before each demo to ensure the audience can easily follow and understand the system. This creates a simpler way to get feedback on a particular vendor.

Evaluate the gathered information and feedback to make an informed final decision. Initiate contract negotiations with the selected vendor, considering terms, pricing and service level agreements.

Need more help to select your perfect match? Check out our Lean Selection methodology — a nine-step process that guides you through your selection journey.

Establish an Implementation Project Team

You should appoint a project manager with prior EHR implementation experience (if possible) to successfully steer and oversee the entire process. Their expertise is vital in ensuring effective coordination and adeptly mitigating challenges throughout the implementation.

Build a cross-functional team that includes representatives from IT, clinical staff, administration and other relevant departments, ensuring a diverse range of expertise to comprehensively address both technical and operational aspects.

Define Roles and Anticipate Challenges

Clearly define roles and responsibilities for each team member. This ensures that everyone actively contributes to the project with a clear understanding of their tasks, fostering accountability and a smooth workflow.

Additionally, anticipate potential challenges in the implementation process and develop contingency plans to address them to navigate unexpected hurdles effectively, maintain project momentum and minimize disruptions.

Create a Communications Plan

To ensure a seamless transition and successful adoption of a new system, a well-crafted communications plan is essential.

Consider the following components:

• Stakeholder Communication: Develop a strategy for clear and consistent communication with staff, patients and external partners. Keep stakeholders informed about changes, goals and progress throughout the project.
• Training Communication: Outline communication strategies for training sessions to prepare users for the new system. Clearly communicate objectives, expectations and benefits during training to ensure user readiness.
• Feedback Mechanism: Encourage open channels for stakeholder feedback, facilitating continuous improvement and quick issue resolution.

Create a Data Migration Plan

For seamless data transfer, minimizing disruptions and preserving the integrity of information critical to your operations, you need to develop a data migration strategy. This should include:

• Data Assessment: Evaluate the existing data and determine what you need to migrate to the new system. Categorize data as essential, optional or redundant to prioritize the migration effort.
• Data Cleaning: Identify and remove duplicate records from the datasets to avoid inaccuracies and inefficiencies. Standardize data formats, such as dates, addresses and names to ensure consistency. Remove redundant or obsolete data to avoid carrying unnecessary information into the new system.
• Migration Testing: Create comprehensive test cases that cover various aspects of the migration process. Identify and address any bottlenecks affecting speed, efficiency or system responsiveness. Execute rollback testing to ensure the system can revert to its previous state without data loss in case of issues during migration.

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Implementation

Having completed the planning and preparation stages for your EHR implementation, you’re now poised to transition into the crucial phase of execution.

Customize EHR to Your Workflows

The success of your EHR transition hinges on how well the system aligns with your unique needs and processes. The goal is to seamlessly integrate the EHR into your daily operations, enhancing efficiency, accuracy and overall patient care.

Follow these steps to customize your EHR for seamless workflows:

• Engage End Users: Involve end users, including clinicians, nurses, administrative staff and other stakeholders, through interviews, surveys or focus groups to gather their insights into current workflows and areas for improvement.
• Configure System Settings: Tailor EHR settings to fit your facility’s needs, covering default views, date formats and language preferences
• Adapt Templates and Forms: Create standardized templates and forms to meet your documentation needs, reflecting specialty-specific terminology and relevant data points.
• Sync Data: Integrate the EHR system with other existing systems in your facility, such as medical practice management solutions and radiology information systems.

Choose a Launch Approach

The launch approach you choose matters. Whether you go all-in at once (big bang) or step-by-step (phased), it affects how well your team adapts and the benefits you get right away.

Below are key considerations to help you determine the optimal launch method:

• Organization Size: If you’re part of a larger organization, consider a phased approach. It allows for a controlled, step-by-step implementation, which works well for complex structures and diverse departments.
• Critical Processes: By focusing on essential workflows first, you can quickly achieve tangible benefits and minimize disruptions to crucial health care activities.
• Staff Preparedness: Whether opting for a big bang or phased introduction, assessing staff readiness is crucial. Ensure adequate training and support mechanisms are in place to empower staff in confidently navigating the new EHR system, fostering a positive reception to the technology.

Perform Pre-Go-Live Activities

It’s time to ensure that every cog in the machinery turns seamlessly for the big day. Below, discover the essential pre-go-live activities you should perform before the final launch day:

• System Testing: Actively conduct thorough testing of all EHR functionalities. Identify and address any potential glitches or issues to ensure a flawless performance when the system goes live.
• Mock Go-Live: Simulate processes like patient admission, data retrieval, medication administration, lab result reviews and interdepartmental communication to identify and resolve issues in a controlled setting.

Based on your pre-go-live assessment, develop an issue resolution plan.

Define roles and responsibilities, outlining a clear process for identifying, escalating and resolving issues. This plan should include a prioritization framework to address critical issues promptly, ensuring minimal disruption to your health care processes.

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Plan Go-Live-Day Activities

This is the moment when your team’s hard work and preparations culminate in the official introduction of the EHR into your health care environment.
To make this day a resounding success, active coordination of activities, adequate support infrastructure and real-time monitoring of system performance are imperative.

• Coordinate Activities: Actively coordinate activities scheduled for go-live day, to execute each task, including setting up workstations, activating user accounts and initiating the system launch promptly.
• Ensure Sufficient Support: Assign support personnel to key areas, such as workstations and critical processes, and ensure clear communication channels for immediate assistance.
• Monitor System Performance: Keep a close eye on response times, data accuracy and overall functionality for prompt identification and resolution of any performance issues.

Develop Training for Your Staff

Ineffective user adoption is a major barrier to realizing expected results from an EHR system. Building a successful training foundation is key to navigating the complexities of EHR implementation.

Here are some strategies you can use for the same.

• Role-Specific Training: Customize training content based on the roles and responsibilities of different staff members.
• Interactive Training: Use a mix of interactive methods, such as hands-on sessions and simulations.
• Post-Launch Training: Offer continuous training opportunities post-launch to address evolving needs.

In addition to the above, you should designate tech leaders within each department or unit who’re well-versed in the technology, serving as valuable resources and providing guidance and support to their colleagues.

You should also plan and schedule training sessions in advance to allow staff members to allocate time for learning without disrupting their daily responsibilities.

Clear communication about training schedules and expectations is essential for a smooth implementation.

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Post-Implementation

After the successful implementation of the EHR system, it’s essential to conduct a comprehensive assessment to ensure its effectiveness. You should:

• Track key metrics, including ROI, actual transactions, turnaround time and clinical quality measures.
• Monitor patient throughput to evaluate efficiency and conduct patient satisfaction surveys to assess the quality of care.
• Gauge physician satisfaction through surveys to evaluate user adoption and training effectiveness.
• Analyze data error rates to assess the accuracy of data input and overall data quality.

Use these questions to jumpstart your EHR/EMR checklist after implementing a new solution:

• Has everyone transitioned to using the new system, or are some staff members still reluctant?
• Are physicians and administrators still using it, or have they returned to paper documentation?
• Was your training sufficient?
• What problems have you encountered so far?
• Are capabilities functioning as you expected? Did they help improve workflows?
• Is information securely stored and shared, as intended?
• How has your vendor lived up to or failed to meet requirements and support needs?

Common EHR Implementation Barriers

As you navigate the path towards a more efficient and integrated health care system, it’s crucial to be aware of the common barriers that might arise along the way. We’ve highlighted the same below.

Data Migration

Transferring data from existing systems to the new EHR platform can be a complex process. Challenges may arise in ensuring the accuracy, completeness and compatibility of data during migration.

Data Privacy

Concerns related to the privacy and security of patient information can hinder EHR adoption. You must comply with strict data protection regulations, such as HIPAA, which adds complexity to EHR implementations.

High Implementation Costs

EHR implementation costs can significantly impact your finances. High upfront costs and ongoing expenses may pose a barrier for smaller health care organizations or those with limited budgets.

Communication Gaps

Poor communication can lead to misunderstandings about EHR implementation goals and benefits.

• Health care providers may feel uncertain about how the new system aligns with their workflows, potentially resulting in resistance to change.
• IT staff may struggle to address concerns or provide adequate support if there’s a lack of clarity on user needs.
• Administrators may find it challenging to convey the strategic vision and anticipated benefits to the entire health care team.

To address these barriers and facilitate the successful adoption of EHRs, you can implement the following strategies:

• Invest in data migration tools and hire experienced personnel to streamline the data conversion process, ensuring accurate and timely data transfer.
• Implement robust data security protocols, including encryption, access controls, and regular security audits, to safeguard patient information.
• Explore government incentives, subsidies and grants to mitigate the financial burden of EHR implementation.
• Provide comprehensive training to your teams, emphasizing communication protocols and collaboration tools.

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FAQs

How should I perform workflow analysis?

Workflow analysis is a systematic process for identifying, understanding and improving your organization’s current processes. Here’s a step-by-step guide:

• Define Objectives: Clearly outline your workflow analysis goals. Understand what you want to achieve and how the analysis will contribute to those goals.
• Identify Stakeholders: Determine who you want to involve in this process such as administrators, departments and any external parties.
• Document Current Processes: Use flowcharts, diagrams or other visual aids to represent each step in the process.
• Analyze Efficiency: Evaluate the workflow efficiency of each step to identify bottlenecks, redundancies and areas for improvement.
• Gather Feedback: Consult with key stakeholders to gain valuable insights about pain points and potential improvements.
• Propose Changes: Develop recommendations for optimizing the workflow. This might involve reorganizing tasks, introducing new tools or streamlining communication.
• Implement Changes: Execute the proposed changes gradually, once approved.

Workflow analysis is an ongoing process. Regularly review and update processes to adapt to changing needs and technologies.

Why should I request product demos?

Requesting product demos is crucial when considering the adoption of new tools or software. Mainly, it lets you:

• Assess the system’s user-friendliness and intuitiveness.
• Evaluate how well it meets your specific requirements.
• Inquire directly with the vendor, clarifying doubts and assessing customer support.
• Compare multiple products if considering options.
• Justify the budget allocation for the product by showcasing its value and benefits.

How much does an EHR cost?

Costs vary depending on whether you select cloud or on-premise deployment.

Cloud products often present lower initial costs, but continuous expenses tied to users, storage and upgrades may accrue, potentially offsetting the initial savings.

On the other hand, on-premise solutions involve a singular payment upfront, incorporating hardware, IT staffing and security systems. While this demands a significant initial investment, it may lead to potential savings in the long run.

According to the Office of the National Coordinator for Health Information Technology (ONC), studies indicate a range of $15,000 to $70,000 per provider as the initial cost of purchasing and implementing EHR software.

For a deeper dive into the specifics, check out our article on EHR costs mentioned above.

You can use our EHR price guide to uncover hidden costs and compare software pricing.

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Next Steps

There are quite a few considerations any health care organization needs to take into account before and after selecting software. Use this guide to compile an EHR evaluation checklist for your particular needs.

We know it’s challenging to compare multiple systems simultaneously. Our free comparison report enables you to compare solutions, generate vendor scorecards, and view product benefits and user sentiments, helping you make informed decisions.

Have you successfully implemented and adopted an EHR system? What did you include in your EMR/EHR evaluation checklist? Let us know in the comments below.