Brainstorming an e-Book on EMR Selection

I spent some time brainstorming quickly some ideas I will include in an e-Book I’m writing on EMR selection. I thought I’d post some of the ideas here so people could provide some feedback on other topics that should be included in a guide to selecting the right EMR. Remember these are just brainstormed ideas, but I’d really appreciate getting your feedback on topics you would like to or have liked to know when selecting an EMR. Something really needs to be done to improve the EMR selection process for doctors.

EMR Selection is like marriage, illustrate the importance of the choice
Narrow down your search is key
Narrowing Features:
   Hosted versus In House (Web versus Client)
   Integrated PMS
   Specialty Templates
   Point and Click (Template) vs. Dictation vs. Hybrid
   Pricing Models
Use appropriate services to narrow selection
Sales Miscommunications
Ask Good Questions
   Don’t Ask Yes/No
   Ask to demo something unique to you (not just their pat demo)
   Ask for a configuration demo
   Private/Public Company
   Portability of Data (if company disappears)
   IT requirements (current infastructure versus future needs for that EHR)
Ask for full client list, not just a few referrals (also indicates stability if have new purchases)
   Ask about training
   Ask about support calls
   Configuration Experience
   Best/Worst features
   Differentiate between clinic specific issues and EMR specific issues
Check out online resources
EMR Consultants – thoughts on good and bad
Set reasonable expectations

Excel File listing features for evaluation

This was just a quick list and obviously there’s a lot of details in each topic. Hopefully it gets your mind working. I appreciate any input/feedback you can provide to improve EMR selection for clinics.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, 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,, 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.


  • One of the biggest helps in the book would be to write about all costs involved with implementing and purchasing an EHR–at least estimates. I use Practice Fusion, which has been rolling out new features periodically. They plan to come out with direct online lab reporting and e-prescription in the next couple of months. As a primary care doc who has a narrow profit margin like a lot of PCPs, cost is the biggest consideration. Practice Fusion is simple to use, which is fine since most docs don’t tend fully utilize a EHR’s full bells and whistles anyway. PF has also been very prompt in responding to any problems I’ve had–they’ve even called me to personally work through the problem. I’ve never had problems with online connectivity with PF. I am aware of your opinion about the free EHR. But you should really include Practice Fusion in your e-book. I’m convinced that if more PCPs knew about PF, there would be little other competition from the other 400 EHR vendors.

  • Jon,
    Thanks for the sales pitch for PF.

    I don’t really plan on endorsing any specific EMR companies in the e-Book instead I’ll be covering the various pricing models that are available out there. PF isn’t the only one to do the free based model and so it would be an injustice for me to just cover them.

    I think you made the case for why people shouldn’t consider Practice Fusion yet. If they don’t have online lab reporting and e-prescription, then what else are they missing that is important? I like what PF is doing, but they still have a ways to go to get all the important features. I’m sure they’ll get there.

  • I like the list so far. From my perspective, a key criterion for selection is usability. Ask the vendor how long it will take the typical user to be fully functional on the software, or even to learn how to use the minimal feature set. Look at the screens, and see if you can figure out how to do what you need to do without any additional instruction.

  • Bill,
    Yes, you’re absolutely right. That’s really covered well in the asking the right questions section and the EMR demo.

    I like the idea of looking at the screen and seeing if you know what you should do. Although, then I think you still need to see it in action, because often you may think it does something when in fact it only does half of what you think it will/should do.

  • Another thing that might be beneficial to list is integration with external systems. For example, HL7 interfaces with RIS, HIS, LIS, EMPI, etc. Also, integration with imaging departments such as radiology and cardiology. Can the EMR display images from these departments natively and/or does it integrate with a system that can provide image display via the EMR? These HL7 and imaging integrations/interfaces usually have costs associated with them, and may be important to some organizations (especially larger ones).

  • Damien,
    Very good point. Great as a point of differentiation and also a great thing to plan for when planning for costs. Thanks!

  • Good list, but one strong quibble: You say, “Ask for full client list, not just a few referrals (also indicates stability if have new purchases)”.

    No vendor I have worked with would ever supply a complete client list. Think about this from the vendor point of view. Why would you want your complete client list to very likely fall into the hands of a competitor? And any large vendor is likely to have, at any one point, clients who are unhappy for any number of of reasons unrelated to the application itself – some clients are simply complainers and whiners no matter what system they are using.

    Rather, I would advise physicians to call every name on the “reference list,” grill them, and even ask for a site visit so you can see the software in use in another office.

  • It’s a good list, as well as the list from the other reader’s Replies/Comments. I think, if anything, it illustrates the complex nature of selecting and implementing an EHR solution.

    From experience, add “proof of concept” to your list. For example, a client should always map several critical workflows and present them to the vendor for demo. Put the onus on the vendor to prove that the application can adequately, effectively, and efficiently meet your clinical workflow requirements.

    It’s one thing for a vendor to “say” that their system “has the ability to send prescriptions electronic”, it’s another when you see the process in action, and it takes 57 clicks to make it happen. You get a better idea of what you’re dealing with. It also helps to expose the “known issues” that the vendor will not normally offer up during the evaluation phase.

  • Mark P,
    You can get pretty close. Plus, you can find people not on the list on various websites to check out the clients that might not have made the list.

    Zach H,
    I like the idea of creating a workflow that you use and having them try to do it. Kind of goes along with having them do a demo that’s unique to you and not just the one they know forwards and backwards.

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