Electronic Medical Records Software

Buyer's Guide

EMR Software Overview

Electronic medical records (EMR) software helps create, store and update patients' digital health records. Common features include digital charting, order entry, decision support and clinical reporting. This software helps physicians qualify for government incentives, meet regulatory requirements and improve overall care quality.

Benefits of EMR Software

EMR software, when properly implemented, yields the following benefits:

• Better quality of care. Features such as integrated drug databases, symptom checks and drug interaction verification help physicians prescribe the correct medications and dosages.

• Improved clinical reporting. When patient information is digitized, it's much easier to create reports that identify and track health risks for individuals or groups of people. Such reports can help physicians intervene earlier when a patient is developing a worsening health condition. An EMR's reporting tools can also make it possible for practices to participate in Medicare payment programs, such as the Merit-Based Incentive Payment System (MIPS).

• Enhanced care coordination. It's important for charts to be easily accessible and legible so they can be shared with all authorized providers in a patient's care team, such as specialists and technicians. EMRs provide a standardized format to clearly present dated patient information that can be shared digitally—which is more secure than printing and transporting or faxing sensitive medical records to authorized colleagues.

Competitive Advantages of Using EMR Software

Whether you are a solo doctor or part of a large practice, EMR software can help you become more competitive by:

Increasing collections. Electronic patient records provide physicians with the necessary documentation to support claims sent to insurance companies, Medicare and Medicaid. Integrated features for E&M coding also help providers code visits appropriately and confidently.

Operating more efficiently. Doctors and administrators can access patient health information without rifling through scores of paper-based records. Other time-saving EMR advantages include the ability to receive lab test results digitally and prescribe medication electronically.

Fostering patient loyalty. EMRs enable physicians to maintain better communication by delivering information directly to their patients electronically. Staying in touch drives patients to come back for future medical needs.

Provider Sizes Using EMR Software

With so many medical EMR companies catering to so many specialties, physicians face a big challenge as they determine which medical software is right for their needs. However, the majority of practices fall under one of these common categories:

• Primary care MDs/DOs and related specialists. These buyers work at private practices that provide internal medicine, family medicine, pediatrics, Ob/Gyn, cardiology, oncology, orthopedics, urology etc. These buyers' various needs are addressed by broad systems with specialty-specific templates.

• Specialists with other designations (e.g., DC, OD, PT, PhD, LCSW). These buyers include chiropractors, psychologists, therapists, counselors and optometrists. Their needs can be met by dedicated systems (e.g., primarily serving their specialty or a small group of specialties) or by systems that serve a wide variety of providers thanks to specialty-specific templates.

• Small practices. These buyers work at small health care organizations, from solo physicians to practices with up to five providers. They may be moving away from paper charts to meet regulatory requirements or replacing an existing EMR. These offices typically have limited or no IT staff, so a solution with robust implementation and support offerings is ideal.
  For more information on small practice buyers, check out our medical software needs cycle.

• Midsize practices. These buyers may have between six and 25 physicians on staff. They're often looking to improve efficiency and care coordination. They may also want to integrate with other health care networks' systems and track information across several locations.

• Large practices. These are practices with more than two dozen physicians on staff. They are usually multi-specialty clinics and therefore need a scalable solution that supports several types of documentation templates.

• Inpatient care organizations. These buyers work for hospitals and acute care centers that need to manage patient rooms/beds, assigned nurses and physician rounds. They usually require robust EMR systems for hospitals that can integrate with a variety of other applications.

Software Related to EMR

EMRs include several types of software based on specific applications or functionalities:

• Cloud-based EMR software: Can be accessed and updated online. These systems help practitioners manage patient health information from remote locations and are typically less expensive because they do not need to rely on servers to host clinical data.

• Mac EMR software: Compatible with Apple devices. These EMRs are either Mac-native, meaning they were built to operate on the Mac operating system, or they are cloud-based software systems that can run on any Mac with an internet connection.

• ONC certified EMR software: Meets regulatory requirements set by the Office of the National Coordinator for Health Information Technology (ONC). These EMRs have been tested to ensure they include a specific number of clinical capabilities, such as patient portal access, the ability to create care plans, robust reporting functions and more.

• Behavioral/mental health EHR software: Electronic medical record (EMR) systems for mental and behavioral health providers have unique features for counselors, mental health clinics and group practices.

• Medical billing software: Medical billing systems help providers generate patient statements, submit claims and more. This software is ideal for practices who want to handle billing in-house and can integrate with EMRs.

Features Guide

A List of Common EMR Features

When comparing EMR software, it's important to know what features are included in each system. The most common features of these solutions include:

EMR Buyers' Top Requested Features

At Software Advice, we help medical practices determine the best software for their budget by discussing their functionality needs. We analyzed a sample of these buyer interactions to show you the top requested EMR features:

According to our full report featuring this data, 28 percent of buyers seek software with patient tracking capabilities (e.g., the ability to monitor assessments, treatment plans, progress notes and initial evaluations). This is likely because practices are preparing to participate in value-based reimbursement programs that place a greater emphasis on patients' clinical outcomes.

The EMR Software Features You Really Need

Some EMR features will be more critical than others depending on when you launched your practice and how sophisticated you'd like your tech set-up to be. Our medical needs cycle report highlights the most important features for different stages in the growth of a small practice.

While the report was written with small practices in mind, organizations of any size can reference our data-driven analysis about why it makes sense to make these health IT investments in the following order:

Read the full report here.

Other related features include:

Charting: Enables medical practitioners to prepare electronic charts through the use of various templates that adapt to their workflow. Charts can be prepared either on a computer or a tablet. You can also receive automated notifications whenever there is an update to a patient chart. In addition, charts can be shared with patients and they can be accessed through a patient portal.

Charting in CareCloud Charts

Patient portal: Provides patients with a safe and secure platform where they can access their personal health information 24/7 from any location with an internet connection. Patients can login to the system and perform various activities such as request prescriptions, update contact information and make payments.

Patient portal in NueMD

E-prescribing: Allows a physician to electronically submit prescriptions to the patient's pharmacy of choice. This feature reduces human error and saves time, as no re-entry of data is required on the pharmacy's end.

E-prescribing in AdvancedMD

Order entry: Practitioners can enter instructions for a patient's next course of treatment through this functionality. Such instructions can include lab, radiology and medication orders. The system automatically checks for errors (e.g., duplicate tests) before transmitting orders electronically.

Creating lab order in Kareo

Decision support: EMRs help providers avoid mistakes and improve care quality with decision support functions. These can be messages (e.g., alerts, reminders or warnings) that can guide treatment plans. For example, most systems check for adverse drug and allergy interactions. Some may also recommend alternative treatments or remind providers to perform a particular test.

Decision support in Practice Fusion

Pricing Guide

For an accurate snapshot of what the software costs, download our EHR Pricing Guide.

FAQs

What Are the Key Functions of EMR Software?

As discussed in "A List of Common EMR Features" section above, EMR software provides several key functions for your business, including:

• Charting: Prepares digital charts in real time to capture patients' medical issues and diagnoses and merges all patient information into a single chart. Many EMR solutions offer customizable templates and users can select fields specific to their needs.

• Patient portal: Enables patients to login and access various information such as their medication history, number of visits to doctor and lab results.

• E-prescribing: Allows electronic printing and transmitting of prescriptions to pharmacies. Also enables physicians to receive automatic notifications related to various interactions with pharmacies such as dosage amounts, allergies and prescriptions.

• Order entry: Allows providers to enter, store and transmit orders for lab tests, medication orders and other services.

• Decision support: Decision support functions include treatment alerts, reminders or recommendations meant to help patients based on their specific conditions and demographics.

What Questions Should I Ask Vendors When Evaluating EMR Products?

When researching EMR software, you shouldn't rely only on the information that vendors provide. You must ask for product demos and keep your questions ready while a sales representative provides a demo. Be sure to ask important questions, such as:

What kind of customer support do you offer during implementation?

One of the major reasons implementations fail is due to lack of proper customer support and assistance during critical stages. Be sure to ask vendors about what plan they have to assist staff members during the implementation process.

How often do you update your EMR software and what updates are you planning for your next release?

Some vendors do not update their products regularly and this question will help you identify the right product for your long term usage. You must look out for answers such as, "Yes, we update our software regularly and offer free updates to our customers," or "Yes, we update our software regularly and our next version is scheduled to be released after three months." Products that are updated regularly are usually better when it comes to addressing customer requests and offering functionality to meet changing regulatory requirements.

What customization options are currently available?

The ability to customize existing EMR features can ensure a smooth transition of storage from paper to electronic records. This can help it become adopted more easily across the medical practice, as it is customized exactly as per the practice needs. Also, custom modules can result in improved capturing and accuracy of data.

What's the Difference Between EHR and EMR?

Many people don't know about the key differences between EHR and EMR. You can find out main ones in our article, "EHR vs EMR – What's the Difference?" In general, both EHR and EMR solutions serve the same purpose, i.e., documentation, and integrate with other providers' systems.

How Much Should I Spend On An EMR?

EMR costs are difficult to generalize because they depend on factors that vary by buyer, such as:

• Number of users

• Required applications

• Size of patient panel

• Availability of IT support staff

• Patient data migration needs

That said, we have some data-backed insights that can help small, medium and large practices determine how much they should budget for a stand-alone EMR system (excluding setup costs). The data in the charts below are based on conversations between our expert software advisors and real medical practices seeking software. The practices surveyed are budgeting for monthly subscription-based EMRs, unless otherwise noted:

Source: EMR Pricing Explained: Your Guide to Upfront, Recurring & Hidden Costs

Alternatively, you could choose to implement a free EMR. We have a list of free EMR solutions with accompanying commentary from real users here.

Are Free EMRs Too Good to Be True?

Free systems work quite well for some users. They are particularly appealing for solo physicians or small practice doctors who outsource their billing to a third-party service and don't need to integrate medical billing or scheduling applications.

However, practitioners should note that there are limitations to free systems and they can come with hidden costs. For example, you may not be able to request any customizations and there could be a cap on the number of users the system supports. We wrote a full report on the pros and cons of free, open source and paid EMRs featuring this decision-making tool:

Source: 5 Easy Steps to Pick the Ideal Free or Open Source EMR

Which EMRs Meet Government Health Care Regulations?

Many practices are in the market for an EMR specifically because they want to participate in government health care initiatives that incentivize the use of health IT.

Whether you were one of the thousands of physicians who got an EMR to cash in on Meaningful Use incentives or you're a first-time buyer preparing for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), it's clear that regulatory compliance is a huge purchase driver for practitioners.

Your best bet for ensuring a system has the robust functionality necessary to meet government health care regulations is to choose an "ONC certified" EMR. These systems have been tested and certified to confirm they offer a set of technological capabilities, functionalities and security requirements approved by the Office of the National Coordinator for Health Information Technology (ONC).

To learn more about how EMRs are certified to meet these criteria, check out our breakdown of the official government-certified testing entities and alternative resources.

What Are Some Drawbacks I Should Watch Out For?

While there are many benefits of implementing EMR software, there are also potential pitfalls. Here are some of the most important ones to be aware of:

Security. One of the most common concerns EMR software buyers have is about data security. Patient privacy and HIPAA compliance are typically on the front of providers' minds, so buyers will want to make sure that the EMR is implemented properly and that standard security features exist in the system. Most vendors are well aware of buyers' security concerns and have taken steps to ensure proper data encryption technology is in place for both on-premise and web-based systems.

User adoption. A second consideration is user adoption, primarily among providers. Some providers find EMRs difficult to use, often because they are accustomed to working with paper charts. Most user adoption issues can be solved with adequate training. The amount necessary typically depends on the user's level of tech savviness.

Interoperability challenges. Interoperability is the transfer of patient data among different EMR systems so authorized providers can access and interpret that data. While vendors are making progress toward achieving interoperability, it's still an issue the industry is struggling with. Fortunately, technologies such as direct messaging make it easier to share records electronically.

Tips & Tools

Build a Business Case for EMR Software

Purchasing EMR software can generate a strong return on investment (ROI) for your medical practice. The top three ROI drivers for purchasing EMR software are:

• Improved patient care

• Reduced administrative costs

• Improved billings and collections

The primary measures of effectiveness are:

• The claims collection rate

• The number of patient visits per day

• The amount of time spent managing faxes and paper charts

• The direct costs of paper charts (e.g., cost of materials, storage, destruction)

Relevant Articles

Here are some recent articles about EMR software you should check out:

• "Patient Expectations For Modern Medical Practices (Pt. 1): Patient Outreach"

• "Patient Expectations For Modern Medical Practices (Pt. 2): Patient-Centered Technology"

• "5 Reasons To Replace Your EHR: Challenges And Solutions"

• "Why a National Unique Patient Identifier Is Good for Small Practices"

• "New Medical Practice Checklist: How To Get Started"

Popular EMR System Comparisons

• Kareo vs. Practice Fusion

Recent Events in the EMR Market

Here are some important recent events related to the EMR software market:

• Epic, Cerner beat out MEDITECH in small hospital EHR Adoption. In May 2017, the small hospital EHR adoption landscape shows that organizations under 200 beds are buying electronic health records from Epic, Cerner and athenahealth at a rapid rate.

• DocuTAP acquires Clockwise.MD. In April 2017, DocuTAP, maker of tablet-based EMR and practice management software, acquired Clockwise.MD, an Atlanta-based company that makes mobile appointment-booking software.

• McKesson and Change Healthcare merge. In March 2017, McKesson Corporation, a provider of health care services and information technology company, and Change Healthcare Holdings, a provider of software and analytics, network solutions and technology-enabled services, announced the completion of their agreement to create a new health care information technology company, Change Healthcare.