EMR and EHR Company Reviews

I’ve been thinking a bit about the best way to fill out the details of my EMR, EHR and HIPAA wiki and in particular the EMR and EHR matrix of companies.

I’ve recently been thinking that I just need to take an EMR company a week and send an email to someone in their company asking them to answer a list of questions. Many of the questions will be similar to an EMR RFP (Request for Proposal), but hopefully a little more general than might be included in an official EMR RFP. Then, I’d post the response to this site and use the information to update the EMR and EHR matrix.

2 questions:

  1. What questions should I ask every EMR company? (I have some ideas, but I love getting feedback)
  2. Which EMR companies should I start with or which EMR companies would like to participate?

In case you’re wondering, I think that my goal would be to help users interested in quickly reviewing information about EMR companies without having to talk to every EMR salesperson and then be on their list for the rest of eternity.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


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  • The kinds of features that should distinguish an EMR, and make it something truly useful and something that a physician will want to keep, should be in line with the following:
    1. usability. It needs to have a user interface that is easy and intuitive to navigate, and presents the user with exactly (and only) the information needed at the time. The interface should not be something that slows down the workflows.
    2. ease of implementation. The setup must be easy and fast. This is difficult to do in a locally installed system, as the entire hosting infrastructure will need to be set up and maintained. A web-based system is dramatically superior in this regard.
    3. integration. An EMR system will work best when it can connect to other physicians, and share clinically relevant information. The notion of true chart-sharing is a next-generation EMR feature.
    4. need for consultants. An EMR setup that relies on the need for consultants to either help create reports, develop templates, modify open-source software for local use, will add hidden costs (consultant costs) to the EMR. A system that does not rely on the need for consultants is important.
    5. proactive support and training. Hosted, on-line training and support is much more available than waiting for on-site training. A system should be intuitive enough not to need extensive training, and (if the system is hosted) on-site training can be avoided. This impacts the speed with which a system can be up-and-running.

    These are the criteria that I believe are the ones we should focus upon, and which can distinguish between the products out there in the market.

    Robert Rowley, MD
    Chief Medical Officer
    Practice Fusion, Inc.

  • Dr. Rowley,
    I like your list of items that a person could consider when selecting an EMR. Some of them are very subjective though. How would you suggest I could get the information on the usability of an EMR system just through a simple email question and answer?

    Certainly I suggest that all users do a demo of each EMR product and a test drive is even better at testing usability. However, my goal in this EMR review is to hopefully help a doctor to narrow down the number of EMR that they have to demo.

    For example, asking a question like “Is your EMR/EHR web based or client server?” will allow a doctor to be able to filter only EMR/EHR that are web based if that’s the kind they are looking to implement.

    So, from your list I could ask EMR vendors:
    1. Describe the Implementation Process for a Doctor:
    2. Name the ways which your EMR will communicate with EMR systems and other external systems.
    3. What percentage of your implementation use a consultant?
    4. What types of training are available to a clinic and at what cost? How and who provides the training?

    Do you think these questions would cover much of what you think is important? I think it’s a great starting point.

  • This is probably a good place to start. And, I agree that “usability” is subjective, but I think it is important, as the user experience will determine whether the physician stays with the product. An interesting “factoid” I read in a recent AMA News article stated that 30% of physicians who install an EMR eventually end up de-installing it. The user experience (usability) is a big factor here. And rip-and-replace is disruptive, as well as potentially costly.

    Of course, we are overlooking the biggest barrier to EMR adoption: cost. Cost of the software, cost of the platform needed to house it (substantial if client/server, negligible if web-based and hosted), cost of upgrades and maintenance, cost of migrating data from legacy systems to the new one. So, a #1 question to ask is how much does the system cost (up-front, per MD or per user, monthly)? This is a (or maybe *the*) major driver of EMR/EHR selection.

    Robert Rowley, MD
    Chief Medical Officer
    Practice Fusion, Inc.

  • Usability is absolutely essential. So much so that I’m very seriously considering starting a PhD program in Health Care informatics and my major research focus would be on usability of EHR software. Should be interesting considering the complexity of usability. The question is how could I as a website easily get a measure of usability that I could share with my readers? I think I might save that battle for my doctoral thesis.

    Cost of course will be a part of the EMR company review. It’s the first question everyone should ask. If the price isn’t within range, then it’s probably not worth wasting your time. The interesting part will be those “old school” EMR companies with incredibly complex pricing. Should be fun to see how they respond (assuming they respond).

    Some other questions I’m considering including:
    -Describe your killer feature
    -Which features of your EMR system make it the best EMR?

    I think I’ll also include a couple simple tasks and have the EMR describe how this will be done in their EMR (ie. scanning a paper document the patient gives you)

  • Usability is indeed an important parameter for assessing an EMR/EHR. Second to cost concerns, usability is the next-most important factor affecting adoption, according to the UserCentric EHR whitepaper found in How to Select an Electronic Health Record System that Healthcare Professionals Can Use. It is a good whitepaper for everyone who is interested in measuring the usability of EHRs.

    Usability is defined as “the effectiveness, efficiency, and satisfaction with which the intended users can achieve their tasks in the intended context of product use.” Some key simple tasks can be used as “tests” of the EHR’s usability, and can be measured as to effectiveness, efficiency and satisfaction. Such tasks would be (1) create an appointment for a new patient; (2) check patient eligibility (e.g. for Medicare); (3) enter patient vitals. The tasks can vary depending on the use-context.

    Using the approach defined in this whitepaper is a good framework for assessing the usability of an EMR/EHR. It is important for adoption. And it is also important to recognize that CCHIT (which may lose its role in credentialing EHRs in the new federal spending plan) does not assess product usability in their criteria-set – a significant weakness in their approach, in my view.

    Robert Rowley, MD
    Chief Medical Officer
    Practice Fusion, Inc.

  • I’d been given a link to that white paper. Looks like I’m going to have to take a few moments to check it out.

    I like the idea of measuring usability by a certain set of tasks. However, it’s still somewhat subjective and dependent on an individual clinic.

    I’ve been considering doing a test of usability based on actual users of a system. Seems like you could draw some interesting conclusions based on specialty, time using the system and how an EHR system’s users rate the EHR software’s usability.

    We’re definitely in 100% agreement that CCHIT doesn’t measure usability and should. The problem of course is that CCHIT gives the impression that it does measure usability even though it doesn’t. CCHIT hasn’t publicly claimed it, but doctors just make this assumption. At least this is my perception.

  • Hi,

    I pan on starting a new company that would assist doctors and clinics to determine which vendor of emr would be the best choice for their practice. I would like to know if this would be a valubale resource. I have worked with some of the vendors and also have installed a fully functional system at a FQHC health center. Please let me know if this would be worthwhile pursuing.


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