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New EHR? Follow These Five Tips


EHR’s have come the distance since they were introduced.


At this point, EHRs are about much more than how encounters are recorded. If you’re looking for a smoking gun, think revenue management. Without a fully unified practice-wide system, you’re in danger of failing to create the type of efficiencies and revenue management you’ll need to compete in today’s value-based healthcare. 

EHR Deinstall

In fact a recent survey shows that now, 90% of the practitioners surveyed will only consider a cloud-based system – one that offers end to end “evergreen” technology.

So, whether you’re installing your first EHR or de-installing a failed system, here are five critical EHR attributes:

Usability. As the top failure point of all failed EHRs, it makes sense to have a pilot program with your forward thinkers and early adopters before making a group wide purchase. Although no physician feels they have the time to do this, look at the downside of wasted time, money, and energy that accompanies the implementation of a system that ‘really demonstrated well at the convention.’

Single-screen functionality. Everything you need to chart an encounter should be on a single screen, so you don’t have to open and close windows just to complete a note. This includes flowcharts, histories, previous notes, and document management –all without changing screens so that the entire patient record and encounter entry is easily navigable on a tablet.

External interoperability. Many physicians have not yet met the criteria for Stage I Meaningful Use, which requires a 2014-certified EHR and 90 days of reporting before October 1. They’re in danger of seeing a 1% cut in Medicare reimbursements. Stage 2 Meaningful Use is an even tougher nut to crack. It requires interoperability with outside systems, including the ability to securely exchange patient data with other healthcare systems. Look for an EHR that is Stage II Certified for Meaningful Use – one that is simple to use.

Internal interoperability. An EHR that doesn’t seamlessly exchange information with your other systems (i.e., practice management, billing, and revenue cycle management) is a huge liability in today’s environment. Billers need automatic charge creation and full access to patient data and encounter notes. Physicians need clinical data to identify at-risk patients and those due for procedures. Management needs a 360-degree productivity and financial view of the whole organization –preferably on management dashboards.

Subscription based. One of the worst problems providers experienced with EHRs was buying a system. Some even found out afterwards that the system they purchased was  no longer supported. In a cloud based system there’s no danger of that because its usage is subscription-based, meaning that the software provider is responsible for maintaining, updating, and supporting both software and hardware infrastructure; which has historically represented the largest cost of enterprise EHR systems.

In a subscription based solution, there are no licenses to purchase, no software to install, and no servers to purchase or administrate or maintain. Cloud software is automatically updated behind the scenes, and more importantly it is backed-up every five minutes without your staff ever having to touch their computer. Cloud software is also browser-based, which means it can be securely accessed from any internet connected device –Mac or PC, Tablet or iPad, Safari or Firefox, Chrome or IE –and this type of open-source browser-based software is platform independent, making it evergreen by definition.

Regardless of how controversial EHRs have been, practices cannot successfully compete without them today. But simply comparing features from several vendors, checking references, checking off a checklist, and then succumbing to the best sales-pitch is not a working methodology. Rather, practice leaders must test the system in their own work environment, and then ask themselves the tough question of whether or not the software they’re considering will ensure their systems are still cutting edge and state-of-the-art three, five, or even twenty years from now.

Physician Billing Services Case Study

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