Today I found a nice blog piece on how providers — largely medical practices, the blog’s core audience — can grill EMR vendors effectively prior to sinking their money into a product. I say “grill” because the questions will force vendors to put up or shut up on several levels, something a lot of non-techy doctors wouldn’t know how to do.
Here’s the five questions, courtesy of the EMR and EMR Insights blog (with a few comments on each):
* When did your company start operations, and can I have 2 references from each year you have been in business?
I don’t know about you, folks, but assuming older companies will produce better results involves some significant risks too. Sure, a high-flying venture-funded partner might go out of biz next week, and that would be pretty terrible. On the other hand, many companies grow less creative and less flexible over time, and take their customers for granted — even if it’s not part of a doofus big vendor’s lineup. What about: “Can I have five references for clients in my specialty?” and “Please sign this contract addendum which addresses how you’ll handle it if your product is discontinued or you close you doors.”
* How many developers are assigned to work on your core EHR product? Where do the developers reside?
I like the Q regarding the size of the development team, which can be make-or-break factor in keeping your product updated and bug-patched. But as for where the developers reside, again, that’s a toss-up. You could hire a vendor with a large but poorly-managed development team, or a small vendor whose team is overseas — but well-managed and effective nonetheless.
* How was your product and company ranked in the Best in KLAS Awards — Software & Services Report – December 2011, and the KLAS Ambulatory EMR Specialty Report 2012?
Interesting. In theory asking about rankings is a good idea, unless you don’t respect the people doing the ranking. (I know my colleague John Lynn isn’t a raving KLAS fan.) I suppose rankings like these can be a touchstone, but they probably shouldn’t be a primary factor in EMR investment decisions.
* Do you have a whitepaper that explains your interoperability platform?
Definitely a good question, but the answer is probably over the heads of many clinicians and office managers making the EMR call. If a medical practice has someone on staff who’s geeky, or an IT consultant is on your selection team, sure, get the whitepaper. Otherwise, I believe medical practices would do better simply studying the literature and asking for a thorough, plain-language presentation explaining these features.
* What are your specific plans for meeting all the Meaningful Use requirements of Stages 2 and 3?
What can I say but yes, yes and more yes. A company that can’t answer this question should be toast.
One final note. How about throwing in “If I can’t get to Meaningful Use within x days, do I get my money back?” Seeing how your vendor reacts should be, um, educational.
I agree with the above list but the last mini comment about MU Incentives and Attestation; John as you know the responsibility is with the practice; you can take the horse to the pond; but it has got to drink!!!!!!!!!!!!!!!!!!!
Good Post, I’ve often said that facilities should be asking way more questions.
Being from the vendor side, I would also include, “Are there any known bugs/defects/inconsistencies with your current system?” I’d be real tempted to follow that up with, “When was I going to be made aware of those concerns?”
I wonder if posts like these will spur the creation of a new consultant role? Something like the Buyer and Seller agent in real estate? Someone who gets to know your facility, interviews vendors, compares products and then presents the facility with a select few based on pre-defined parameters set out by the facility.
I totally disagree with this article. First let me be clear, my company is not an EMR vendor. The questions proposed in this article do not reveal the EMR vendor’s current and future capabilities. These questions only dissect the past and do not ask the EMR vendor to describe how they handle the toughest challenges facing healthcare. Here are a some questions that will reveal the most capable EMR vendor for your organization.
1. How does your EMR system share data with other EMR systems?
2. What does patient data integration mean when the same condition might be coded differently in different databases (ICD-9, ICD-10, SNOMED) and in different languages(i.e. English, French, Spanish, etc?)
3. How does your EMR system handle security and privacy? (Note: privacy is very different from security)
4. How does the EMR system handle patient records that are currently on paper? (meaning, does the EMR system have document management capabilities.)
Cheers
Anthony,
This article was written by Anne, not me. With that disclaimer, I think the intent of the question is good if it’s a practice that wants stimulus money. Understanding if that EHR vendor can get you there would be important to learn.
Of course, as a long time reader, you know how I feel about the EHR incentive money.
Hi Michael,
I think your comments are dead on, but for a slightly different article. In context to this article, I could answer your questions for what I would consider to be a very typical established vendors view.
1. How does your EMR system share data with other EMR systems?
A. Our systems is an enterprise level system and works with any of our partner products. Translation, our product only works with our product / product line, we can’t afford to risk full integration with other products.
2. What does patient data integration mean when the same condition might be coded differently in different databases (ICD-9, ICD-10, SNOMED) and in different languages, (i.e. English, French, Spanish, etc?)
A. Our system is ICD-10 ready, any previously coded claims will remain intact, in regards to language usage, all text areas for data entry could be written in Elfen, the data is stored and reported out based on the field it is entered, not the language. Translation, actually, I’ll stick with the A. as my answer as well.
3. How does your EMR system handle security and privacy? (Note: privacy is very different from security)
A. Our system meets all HIPPA compliance standards, in addition there are several key features built in to document the use and release of PHI. Translation, patient privacy is always going to fall on the head of the facility. NO matter how good an EMR is, it is only as secure as the people using it.
4. How does the EMR system handle patient records that are currently on paper? ( Meaning does the EMR system have document capabilities?)
A. (This is a very relevant question to the article.) I usually recommend facilities look for a system that allows them to scan in documents as needed. Both systems that I’ve worked with, do have add-on features that allow a facility to scan in entire charts. However, I usually recommend this to be done on an ongoing basis. Meaning, don’t just start at AAiden, John and start working your way to Zgrieke, James. Scan charts in a few days ahead of the actual patient visit, if you feel you have to. I know many facilities that view their EMR implementation as a go forward process, they draw a line in the sand and from that date forward everything is done electronically; the past is the past.
I responded to these questions, to make a point, the questions you are asked should be directed at the future of our industry. The only difference I would make is placing the words, Why doesn’t a system have to …? Interoperability (sp?) is the obvious starting point, however, that wasn’t the point of the article. The article was written about dealing with what we are being sold and have to choose from; unless I’m wrong, in which case I believe this is a very long posted egg on my face.
Regards,
I agree with Michael and the last person to comment. There will definitely be rehearsed answers to each question no matter the vendor.
We have taken a different approach since we started as an organization. We started off as a vendor-neutral company and had the opportunity to review more than 60 different vendors first-hand which has led to great insight.
1. How does your EMR system share data with other EMR systems?
A. Our systems is an enterprise level system and works with any of our partner products. Translation, our product only works with our product / product line, we can’t afford to risk full integration with other products. <– at this point it's best to know if the vendor can offer post-implementation and integration services, and for what cost to the client.
3. How does your EMR system handle security and privacy? (Note: privacy is very different from security)
A. Our system meets all HIPPA compliance standards, in addition there are several key features built in to document the use and release of PHI. Translation, patient privacy is always going to fall on the head of the facility. NO matter how good an EMR is, it is only as secure as the people using it. <– Oorah! Great translation. Adhering to any compliance is more than just software. Its a lifestyle. It works on an administration, technology, security and privacy, and practical application basis. These are all ongoing and one mistake on any of these can cause a leak of epic proportions. Its imperative to offer continued education and audits annually. This is not something a typical vendor will offer.
That's my .02, but thought it should be brought up.
Thanks.