How To Select an EHR for Your Independent Practice

By: Collin Couey on November 22, 2022
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If you are an independent or small practice owner or admin who is in charge of selecting an electronic health record (EHR) system, you want to ensure you are getting the right software for your budget and needs. 

However, it’s important to understand how to go about EHR selection. If you fail to adequately plan, you risk paying too much money for features you don’t need, or on the flipside, not getting the right features which might stifle the growth of your practice. Finding the right software ensures you get the largest return on investment for your independent practice.

To help you pick the right EHR, we'll cover helpful steps inspired by Gartner research [1] and an interview with New York-based periodontist Dr. Richard Nejat.

Dr. Richard Nejat [2] is a New York City-based, board-certified periodontist offering leading-edge dental implant placement and gum surgery. He’s the head doctor at Advanced Periodontics & Implant Dentistry and has had several hands-on experiences when selecting new software to help his practice grow.

Before you begin, pinpoint your purchase drivers

According to Gartner, 73.9% of physicians were employed by a hospital or health system or other corporate entity by the end of 2021 [1].

One of the reasons these independent practitioners might be moving back toward a larger healthcare organization is the burden of procuring and maintaining an EHR, particularly if the practice is unsatisfied with their purchase decision which can result in wasted money and a lot of other frustrations. 

But there is a way to make sure that your independent practice is not wasting money on unneeded EHR features or maintaining a bulky EHR that your staff doesn’t like to use. Focusing on pain points that your practice is experiencing in its everyday routine will help you to hone in on what you need an EHR system to help you streamline and automate. 

First-time buyers might be looking at things such as affordability or basic functionality, like paperless charts, whereas a more established independent practice might have outgrown their EHR and are looking to upgrade so that their software stack can work seamlessly between different office buildings.

Dr. Nejat’s old EHR didn’t offer any paperless features, which was making it difficult to grow his practice. In order to continue to grow, he needed to go to find a new solution:

“Now that we wanted to go to the next level, we really needed to start thinking through software. We gave our old EHR five or six years, but it was enough. So we decided to go back to the drawing board to find something else.”

Dr. Richard Nejat

Head Doctor, Advanced Periodontics & Implant Dentistry

Now that you have a handle on why you’re looking for an EHR in the first place, it’s time to begin the software selection process.

Step #1: Put together a team of stakeholders to evaluate the software options

You might understand what you need from a piece of software from the clinical side of things, but your office manager will know what functionality you need when it comes to billing or scheduling. Just like your IT team will know what your practice is physically capable of achieving, given your resources.

Dr. Nejat understood the importance of bringing in different perspectives when they began their search for a new EHR: 

“Our office manager knew what she wanted from the billing side of things; that was more her world. I knew what I wanted, clinically, and the IT guys knew what we could physically do.”

Choosing software shouldn’t necessarily be a fast process because, ideally, you want to find the perfect fit for your practice the first time around. Switching systems can be costly due to cancellation fees and the data transfer headaches that it can cause. 

Look at the important parts of your practice that the electronic health record system will serve—billing, data management, paperless charts, etc.—and then find key stakeholders on your staff that can help inform what your current system is lacking and what holes you need your new system to fix. 


Once you have your selection committee in place, hold a kickoff meeting to gain a few key insights:

  • Gather initial feedback about what pain points everyone has with the current software.

  • Discuss any software they might have used in previous roles or jobs to see if those might be a better fit.

  • Set expectations (based on role, timeframe, etc.) for each member of the team early on so that everyone is on the same page. 

  • Start working toward getting team buy-in early on. When your staff understands why you’re switching software and sees the benefits of new software, they will be more likely to use it.

Step #2: Build a feature and functionality shortlist

Dr. Nejat and his team of stakeholders came up with a checklist of key features and functionalities that were mandatory during their search which made narrowing down a list of potential vendors significantly easier:

"The shortlist made it a lot easier to focus on what software was going to work. It made it easy to evaluate vendors. Did the vendor have what we needed? Nope. Okay. Next. And then we went down the whole list of potential vendors."

Once you’ve assembled your team, you’ll want to break down your practice’s needs in a few different ways:

  • Functionality

  • Training and support

  • Pricing

  • Deployment

The most important aspect of choosing a new piece of software is understanding what you need it to accomplish for your practice. Creating a shortlist should be you and your team’s focus until you get your software options narrowed down. 

When developing your shortlist, make sure to separate your needs from your wants. You should have a list of required features first and foremost while also keeping a list of nice-to-have features that can be the deciding factor between two vendors that both meet your requirements.

EHR Features Overview

To give you a starting point about what EHR features are usually most important, here’s what’s required for products to qualify for our FrontRunners:

  • Charting: An electronic record of patient clinical documentation, created and stored digitally.

  • Decision support: Ability to provide users with patient-specific information relevant to treatment plans.

  • Coding assistance: Automatically generated E/M codes based on information collected during patient charting as well as rapid ICD code lookup.

More EHR Features

Nice-to-have features are the ones you would enjoy, but don’t necessarily need in order to function. These can include things like:

  • Patient portal: A secure system with which patients can access personal medical information, test results, or secure messages from a healthcare provider.

  • Reporting and analytics: Generates reports for clinical and practice data to provide clearer insights.

  • Patient scheduling: Automates the process of scheduling appointments.

  • iPad support: Allows you to use the software via iPad during appointments.

Once you have your shortlist narrowed down, stick to it. Try not to deviate from your required features once you start doing more research into what different software vendors are offering.

Step #3: Read reviews, and get recommendations from colleagues

Once you have your shortlist and have narrowed down the list of potential vendors that work for what your practice needs, it’s time to talk to colleagues, read reviews, look at product comparisons, and speak to people who understand the market thoroughly.

You can do as much individual research as you want, but one of the best ways to determine if an EHR software vendor is right for your practice is to see how a system worked for someone else in your field. 

Dr. Nejat had some advice for practices looking to switch to new software:

“You have to talk to other people who have the software. People who use it. You need to ask questions about what works and what doesn’t. How long have you used it? What do you like? What don’t you like?”

If you’re relying solely on vendor websites, you might only see the good—or what they want you to see. You might miss out on some of the nuances that only become apparent once you’ve had hands-on experience with the software. The last thing you want is to choose something because it looks pretty but might not be able to help you grow your practice because it doesn’t actually do what you need it to do.

Software Advice lets you read what other small practices like you think about the software they use by breaking the software down into four categories: 

  • Ease of use

  • Customer support

  • Value for money

  • Functionality

You can also compare vendors side-by-side to see how they stack up against each other, or find common alternatives that share similar features.

Product comparison screenshot of different EHRs

Step #4: Speak to vendors once you have all the pieces in place

You’ve gotten your panel of stakeholders together, narrowed down your must-have features into a shortlist, and have gotten recommendations and looked at reviews—now it’s finally time to talk to the vendors who meet your requirements.

When approaching a vendor, you want to ask for at least two different demos:

“Once we identified a vendor we thought would be good, we’d schedule a demo. My office manager would take the first demo to see if it met our requirements. Then we would do another demo with me to see if it met the clinical side of things.”

During your demos, you want to see firsthand how the software will support your important practice processes. For example, you want to see how you can upload patient charts, intake forms, how billing works, etc. 

For the first demo, include key stakeholders who will be using the software daily to see if it fits your needs.

Any subsequent demos should be used to determine more technical things. If you have an IT representative, they should take a look to see if there will be any compatibility issues, such as data storage, server hosting, downtime times, etc. 

Initiating software negotiation talks with the vendor

Avoid budget overruns by evaluating vendors on total cost of ownership, including potential hidden or additional costs, such as interfaces with third-party solutions, data migrations, end-user training, cybersecurity software and insurance, or exit costs.

It’s important to remember that, ideally, you’re purchasing software as a long term investment, so you should be thinking about the software vendor as a partnership or relationship. 

Dr. Nejat compares it to a marriage:

"It’s a long-term relationship you’re getting into. Do your research to create a shortlist, speak to other people who have the software, get the pros and cons, and then go get married.”

He’s not wrong. You want a software partner who is invested in seeing your practice succeed. If you view it solely as transactional, you’re losing out.

Software partners will work with your business every step of the way to make sure the software they provide will help your business thrive. When it comes to finding a software partner, you’re going to want to focus on two things:

  1. Make sure the software provider’s business goals align with yours

  2. Excellent customer service and support

For more advice about how to approach software demos to get the most out of them, check out How To Cut Through the Sales Pitch During Software Demos.

Making the right decision takes time and effort but is ultimately worth it

Small and independent healthcare organizations that take upgrading or switching EHRs seriously by going through each step outlined in this article will see better long term results that will lead to greater growth. 

EHR selection checklist

If you still don’t know where to start or need a little assistance, we’ll help you find the right software for your needs and budget in 15 minutes or less, for free. Schedule a call or click here to chat with a software advisor now.