Electronic Health Records Software Systems

What is EMR Software?
Electronic health records (EHR) software, also known as electronic medical records (EMR) software, are software systems that provide a longitudinal, electronic version of a patient's health history. Information commonly found in an EMR includes a patient’s progress or SOAP notes, problems, medications, vital signs, past health history, immunizations, laboratory data and radiology reports, to name just a few. In addition to storing patient information, these systems are often integrated with medical billing software or practice management software for a fully-integrated workflow. The market offers a wide range of web-based EMR systems, as well as systems installed on-premise.

EMR software, when properly implemented, has potential to dramatically change the healthcare landscape in the United States. When compared with traditional paper-based charts and record keeping, computerized medical records can reduce overall healthcare costs, increase efficiency, decrease errors, and provide organizations with vast amounts of information for data mining. In short, the adoption of EHR software, and even personal health records (PHR), represents a sea change in how the healthcare industry takes care of patients.

EHRs are designed for inpatient and outpatient use by health providers. As of 2009, approximately 20% of office-based U.S. physicians are using an EMR with basic features, compared with only 7% of hospitals.

Benefits of Digital Health Information
Whether using a web-based system or an on-premise system, doctors and hospitals should see a number of benefits when moving to digital record-keeping, such as:

• Improved data security;
• Reduced documentation expenses;
• Shorter billing cycles;
• More accurate coding;
• Improved clinical decision making; and,
• Better documentation.

In short, EHRs can increase a practice or hospital’s ROI and improve patient care. Other benefits may include reduced storage costs (from converting paper charts to digital form); eligibility for Pay-for-Performance (P4P) programs; drug to drug interaction checking; and reduced transcription costs.

How to Find the Right EMR Software
Before a physician purchases an EMR system, they’ll need to review a number of important considerations. These include questions such as:

• Is the software appropriate for your specialty?
• Should billing and scheduling be integrated into one system or should the new software interface with existing systems?
• How easy is the software to use (accessible navigation, use of familiar terms, intuitive interface)?
• What kind of maintenance and support package does the vendor offer?
• How viable are the companies being evaluated (financially and strategically)?
• What are the long-term costs of a particular system (license fees, support fees, transaction costs)?
• Does the software meet or exceed the criteria established for Stimulus Bill incentives?
• Which deployment option is appropriate (on-premise or web-based)?

We recommend that practices “think big, start small and grow quickly.” That means buying into a big vision of how effective the practice will become by going digital. At the same time, it means accepting that you won’t realize that vision overnight.

Common EHR Features
What information a practice or hospital needs to collect, as well as the specialities that are represented, will determine what features they’ll require. The features and capabilities of the over 300 systems on the market today vary widely. However, there are a number of core features that a provider will want to know if electronic medical record companies are offering. For example:

• Computerized physician order entry (CPOE);
• Recording patient demographics;
• Maintaining a problem list of diagnoses;
• Prescribing electronically (e-prescribing);
• Maintaining an active medication list for patients;
• Implementing drug/allergy checks at the point-of-care;
• Sending patient reminders;
• Sharing patient information between providers;
• Providing patients with digital copies of their health information;
• Checking insurance eligibility and submitting claims electronically; and,
• Data sharing with immunization registries and public health agencies.

Many software vendors offer modules that have different features, which a provider can implement after the initial software implementation. The ideal situation however is to thoroughly evaluate what your needs will be both now and in the future to complete the implementation process all at once.

If a practice has hardware, they’ll also want to ensure that the software can interact seamlessly with it. For example, a cardiologist will want their cardiology EMR program to be able integrate with an echocardiogram.

Challenges of Evaluating EMR Systems
One of the biggest challenges when evaluating EMRs is sifting through the sheer number of choices on the market to determine if a particular product meets your needs. As mentioned above, a physician or hospital will need to ask a variety of questions to determine if the software is the right fit. Once a provider does that, there are still even more challenges ahead.

Assessing the viability of an EMR software vendor is one of the more important challenges. Consider this scenario. You spend three months selecting a new EMR system and another three months implementing and training. Your office staff get accustomed to it. Then you learn the software vendor has gone out of business. No more support, no new upgrades, and no delivery of that additional module they promised would be available soon. Here are some questions to ask when assessing the viability of a software vendor:

• Does the vendor generate enough cash flow from operations to support continued investment in development and support?
• Does the vendor have adequate working capital (current assets minus current liabilities)?
• What does the vendor’s product development road map look like?
• Is the vendor focused on your specialty and the product you are buying?
• Is the vendor large enough to acquire other companies or small enough to be acquired?