"Electronic Health Records in Ambulatory Care -- A National Survey of Physicians." N Engl J Med 359(1): 50-60.
According to a recent publication in The New England Journal of Medicine1 :
Never the less, most (93%) physicians who use EMR's are satisfied with the systems.
Physicians with fully functional systems were more likely to be satisfied than physicians using basic, or partial systems.
Therefore: It is essential to have professional advice and assistance when:
- Selecting
- Purchasing &
- Implementing Electronic Medical Record Systems.
Wolfson Consulting, Inc. provides such advice and assistance. Call us at 303-293-3754 for further information.
1. DesRoches, C. M., E. G. Campbell, et al. (2008). "Electronic Health Records in Ambulatory Care -- A National Survey of Physicians." N Engl J Med 359(1): 50-60.)
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The Electronic Health Record May Be Gaining Ground
In 1996 an article published in Archives of Family Medicine announced, "The electronic health record may be gaining ground". The article quoted the results of an online, survey of 364 provider organizations.
- "75% of provider organizations had plans to implement EHR infrastructures
- 56% "expressed confidence in the industry's ability to meet the Department of Health and Human Service (HHS) EHR implementation timeline".1
In July, 2007, an article published by the American Academy of Family Physicians stated that
"Half of family physicians responding to a recent survey reported their practice uses or is implementing an electronic health records system."
Ballas, E.A., "The Clinical Value of Computerized Information Services. A review of 98 randomized clinical trials." Archives of Family Medicine", Vol. 5. No. e, May 1996.
However, physicians in solo and small group practices may not share this enthusiasm. In a recent study published by Health Affairs, Miller found that barriers to EMR use include,
High initial financial costs,
Slow and uncertain financial payoffs, and
High initial physician time costs.
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This is where an experienced Practice Management Consultant can be valuable.
Contact Wolfson Consulting, Inc. by clicking on CONTACT INFORMATION or by calling 303-293-3754.
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There are also many valuable evaluation tools to be found on the Internet.
I found one publication to be very helpful: How to Select an Electronic Health System, by Kenneth Adler, MD MMM. It was published in the February, 2005 issue of Family Practice Management. Click HERE for a link to the article.
Dr. Adler suggests a multi-step guide to complet the process of selecting an Electronic Health Record. I have summarized the steps below.
Form a physician-led election committee early in the selection process.
Be sure to include your office manager or practice administrator, since he or she will have to be heavily involved in implementing the EHR your group chooses.
Before you start looking at specific systems, determine what you hope to accomplish with an EHR and identify the functionality you'll need to meet those goals.
Develop a request for proposal (RFP). This will take significant effort, but it will impose some order on the responses you'll receive from vendors and make comparisons easier.
To shorten the list of vendors you'll send RFPs to, consider whether the vendor has already developed an interface with your practice management software, whether it markets its product to practices like yours and how it performs in published ratings.
If you are dissatisfied with your practice management software, it would be a good idea to replace it before you select an EHR.
Published ratings of EHRs from organizations like Aurora Consulting Group, the annual TEPR conference and the AAFP's Center for Health Information Technology can be valuable resources to your selection committee.
You should narrow the field before scheduling vendor demonstrations to ensure that you won't have an impractical number of sessions to attend.
During vendor presentations, be prepared to present the vendor representatives with patient-visit scenarios to document so that you'll see more than a canned presentation.
Develop a rating form and be sure that each committee member fills it out at the end of the demo.
Check several references for each EHR you're considering, and go beyond the list of references the vendor provides you.
A vendor rating tool can help you narrow your list of contender to two or three, which will be the focus of your site visits.
Your rankings should be weighted to reflect the relative importance to your group of functionality, cost and vendor characteristics.
Don't underestimate the importance of service, training, implementation support and the long-term viability of the vendor and the product.
A thorough analysis of each vendor's costs is critical; a spreadsheet can help sort out the costs and facilitate comparisons.
When planning site visits, target practices that are similar to yours in size and, if possible, ones that use the same practice management software that you use.
Select your winner and a runner-up; having a good second choice will give you more negotiating leverage.
Negotiate a contract only after shoring up the support of all the stakeholders in your practice.