Added under EMR Tips by Andres Paglayan in July 8, 2010
We are seeing and about to see even more EMRs/EHRs (Electronic Health Records) offers in the wild hyped by the stimulus package money to be pured into “early” EMR/EHR adoption.
The scenario is both good and bad for buyers. The growing offer along with the increasing quality of the products makes it good. At the same time, the myriad of options makes it difficult and time consuming for a practice to assess the existing offers and to make a good and educated decision about the way to go.
The rich offer complicates things even more. Pressure to sell can make some vendors say yes to anything without mentioning caveats and bias answers to your questions for their convenience, after all, that’s what salesmen are paid for.
Tap your peers experience, using their feed-back to cross out vendors from your list.
Ask them if they are using any EMR. If they are happy with it, and what problems they have.
If wanting to do some note work in the subway with your iPad, accessing some records while on vacation or at a friends house, or to refill prescriptions from your phone (but not while driving) are things that you or the professionals documenting into the system would want to do, then you need a multi-platform system that is not confined to a Windows exclusive environment.
There are many other operative systems other than MS Windows. Mac OS, Linux, and even the new smart phone and touch pad platforms such as that of iPad and Android are all growing their market share making the user terminal a much colorful rainbow than it used to be.
Even when you are facing the expenditure of several thousand dollars, most vendors in the EMR industry will still limit your scouting experience to a quick demo or to a video presentations without letting you have a full grasp of what using their system means.
This gets even worst when you have to previously sign a long-term contract for something you still don’t know how interacting with it will be. Have a positive bias towards the vendors that let pilot test drive the system for free before any commitment.
Sounds fishy? If a vendor is confident about its product and about the users’ experience with it, then giving it away for a free pilot drive test should only bring them more business.
Even more, with todays ubiquitous virtual server and other technologies alike, if they are incapable to provide a freebie environment for serious potential buyers that alone should rise justified suspicions on their technical abilities and customer friendliness.
This little guideline can help EMR/EHR prospectors align some ducks. Add these points to what you already have as guidelines.
Ask the applicable questions to your vendor. After every answer, always say: -”Show me how”.
Can you get a no commitment free-trial?
Even if you are not convinced about using the system from a given vendor, don’t let pass the chance to “play” with the system if they let you use it for free. You will need no more than twenty minutes to get a feeling on how using that system on a daily basis would be.
Bear in mind that even though many try to make it as easy as possibly, using them is still a little harder than shopping at Amazon.
Will you be running unforeseen costs in IT resources you don’t even know about?
Ask very well about the hardware and other licensing needs. You might be closing on the price of the EMR system just to realize that the platform to running it goes up to several thousand dollars in hardware and another piece on operative system and database licenses.
If you need to install their software in your computer and you don’t have an in-house IT, it might signify yet another batch of hidden costs if you have to hire third party help or contract specialized support to install and update the software.
Is it easy to use?
This is very subjective and only up to you. Don’t settle for demos, get the hands dirty and start pointing and clicking to see what it takes. Get the system’s documentation and have a feel. Is it composed of more books than you had in College? Is it reasonably presented? Is it easy to understand?
Does it document all your client’s needs?
This is a trade-off between pricing and features. If you can write down all the things you wish the system will do, then do it, run the list through the vendor and see how it compares to your wish list. Probably the $2k system can do 95% of what the $100k system can do. You do need a comprehensive feature list.
Do you have to pay for upgrades?
Find out about their versioning and upgrading policy. Compare answers with the reality. Ask what’s the current version, and when they released the former ones, if you see one release per year you might be prepared to pay for an upgrade every couple of years.
Can you be let without support at a given time?
Find out about support caducity. This goes closely related with the application versioning history and upgrades. Some vendors won’t support a version that is two releases behind. And will make you purchase the upgrade if you need support. Double check the facts, call support and ask which one is the oldest version they are supporting.
Do you like the taste of their support?
Call their 24/7 support number at an odd time and see what happens. That’s to expect when you really need them.
Do you need more “modules” to make it work?
Is it in the core or in a module? if you hear the word “module”, chances are that many goodies are modular and you’ll have to pay extra for them. Ask for all the available modules and the pricing for a full system.
What if you need something that is not in the system. Can they provide a new feature in an acceptable time?
If a vendor tells that they will include any of your requests, and if your business is potentially big for them, then it makes total sense to ask for a demonstration of turn-around capabilities. Request a trivial change, such as adding an inexistent data field, and see what it takes, or even if they are up to do it.
Do they take care off all backups and security?
Sometimes the backup and disaster recovery strategy are left behind and you realize that you’ll have to duplicate your environment for redundancy right after you purchase or contract the system. Think those scenarios through before hand and evaluate the real cost of backing up at least once every day, having at least two weeks of backup history, and what does it take to have disaster recovery in place.
Can you get off the hook next month?
Even for marriages that are supposed to be life-long, people will go ahead only if pre-nups. Is disengaging from your vendor a simple transaction or a costly, tedious and bothersome one?
Can you have your data? Meaning all of it and in an usable way.
Are they “data friendly”? Find out how much they are. In these times, and way more in those to come, data as a second language won’t sound weird but necessary. You need a clean interface to all your data. Find out if they can give you access to a real time replica so you can access it with powerful reporting tools (such as Crystal Reports). Can you take your data home? If you request a “database dump”, can you get one? Some vendors might not be as transparent as you wish when it comes to access the data, make sure yours is. i.e. Run away (and fast) if the data is to be given printed out.
Can you export-import your data into another system?
This is a worst case scenario, but will happen sooner or later, nobody knows when, but in one year, in ten or in twenty, your company may need to migrate data to newer systems. Take a peek at the database tables. Are they named in cryptic ways? or they have human readable names?
If you got a no to any of the former questions, you are probably facing a deal that will haunt you in the future.
This post is open to discussion. Please fell free to share with us any question you have or any experience you had.
Thank you for reading and happy shopping!
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