Switching EHRs? Consider This

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Posted By: Roberta Mullin October 3, 2013

Ask Joy: This Week – A Wish List for those Making the Big Switch

It’s estimated that 23 percent  of physician practices are ready to trade in their current EHR system for a new one. According to the Black Book Rankings report, 80 percent of those ready to trade will do so within the next year. This week’s question comes from a practice that falls under the category of “ready to upgrade.” Their legacy system is clunky, doesn’t integrate well with their other systems, and overall, doesn’t match their specialty needs. While they’re on the hunt for a new EHR, let’s take a look at what they may want to consider.

We have three providers in our family practice and we’re all unhappy with our current EHR. We’ve been on the system for two years, is it too late to switch to a new one? How should we go about figuring out which EHR will be the best fit for our group?

First of all, it’s important to know that you’re not alone. Many among your peers are in a similar situation. And the reasons to purchase, upgrade, or switch EHRs are plenty. Common complaints from doctors are that their EHR:

  • is slow
  • is difficult to learn
  • doesn’t integrate with other systems in the practice
  • is not certified for Meaningful Use Stage 2
  • doesn’t adequately meet the practice’s needs
  • vendors are unresponsive
  • support and training is insufficient
  • causes them to spend too much time “fighting technology” instead of focusing on patients

There are plenty of things to take into consideration when you’re looking for a new EHR. Here’s my take on an all-inclusive wish list of characteristics for the perfect EHR:

  • Specific – will your new system adapt to your practice’s specific workflows?
  • User-friendly – is it smart, fast, and intuitive? Your next EHR should allow you to get to your most frequented areas with the fewest mouse clicks
  • Contemporary – is it certified for Meaningful Use Stage 2 & 2014 eCQMs? If it’s not already on this list, when will it be?
  • Adaptable – can your new EHR adapt to changes in healthcare reform? This often comes in the form of cloud-based EHRs, as updates and maintenance happen on a system-wide server level, instead of at an individual practice level.
  • Unified – is the new EHR already integrated with your lab, radiology company, and pharmacies? This will come in to play for anyone going through Meaningful Use Stage 2.
  • Sensible – how does the new EHR manage tasks? Are all tasks located in one place, or in multiple places throughout the system? The user’s to-do list should be easily accessible and comprehensive.
  • Methodical – how meaningful is the EHR’s meaningful use reporting? If you’re not meeting a set of criteria, does it give instructions on how to get better results?
  • Relevant – the new EHR likely has CQM reporting. But does it capture all the information needed for the measures you choose to report on?
  • Qualified – are you interested in reporting PQRS measure directly from your EHR? If this is a priority for you, choosing a PQRS-qualified EHR might be your starting point.
  • Seamless – will your new EHR integrate with your Practice Management System & Patient Portal? Ideally, you want information to travel seamlessly among these systems.
  • Complete – will the new system meet your practice’s clinical, financial, and administrative needs? How does it handle the revenue cycle?
  • Empowering – your goal is to be more productive and profitable while providing better care for patients. Does the EHR allow you to do this effectively?
  • Connected – does the EHR make it easy to submit syndromic surveillance and immunization information to registries?
  • Prepared – is the EHR ready to implement ICD-10 coding?
  • Stable – is the EHR vendor financial secure? What is the likelihood that it’ll be around in five years?
  • Sophisticated – will the new vendor be able to extract data from your legacy EHR and migrate it to the new system?
  • Educational – what level of training and support is available for the new EHR and in what formats? Continuous education is the key to any successful EHR implementation.

Good luck finding an EHR that can meet all of these demands. If that’s not enough to think about, might I add that the following is important to keep in mind:

  • Upgrading to a 2014 Certified EHR Technology does not qualify for hardship exemptions, according to CMS
  • Timing-wise, 2014 offers a lower-risk transition to a new EHR since the reporting period for Meaningful Use is only 90 days, no matter the stage or year you’re attesting. Timing might be as good as it gets to make the switch.
  • Consider implementing your new EHR system in parallel with your existing one. While you track Meaningful Use on your old system, you can test data conversions into the new system, so that after your 90-day reporting period passes, you can perform a final conversion and go-live with the new system, giving you the maximum time to learn it before reporting begins again in 2015.
  • Make sure you’ve learned from past mistakes. The issue is not always software related. Automating bad practices will produce bad results no matter which EHR you use.
  • Ensure that all clinical data from your legacy system is migrated or stored in an archive solution. You are required to maintain patient records from for at least 7 years, and up to 21 years for pediatric patients.
  • Data migration and conversion can be extremely complex. Make sure you pre-plan and have an effective strategy for this.
  • When adopting a new EHR, adopt a culture of change within your organization. Remember, to the whole point of this is to improve patient outcomes.

About the Author: Joy Rios has worked directly with multiple EHRs to develop training programs for both trainers and practice staff. She has successfully attested to Meaningful Use for multiple ambulatory practices in both Medicare and Medicaid. She also authored the Certified Professional Meaningful Use course for www.4Medapproved.com. Joy holds an MBA with a focus in sustainability. She is Health IT certified with a specialty in Workflow Redesign, holds HIPAA security certification, and is a great resource for information regarding government incentive programs.Ask Joy is a regular column on 4Medapproved HIT Answers.