Selecting the right EMR for your practice is one of the most important business and clinical decisions you can make. With a range of potential EMRs available in each province, how should you choose the right system for your specialty and practice size?
In addition to viewing EMR information and rating data on CanadianEMR, the following tips are provided to assist you with EMR selection:
- Are you ready for an EMR?
- Is the EMR appropriate for your specialty?
- Is the EMR appropriate for your practice size?
- Ensure you receive sufficient training.
- Post implementation support.
Are you ready for an EMR? Assess your practice’s readiness to adopt an EMR system and develop a list of requirements for your practice. Evaluate both your own and your staff members’ readiness from a computer use and commitment perspective, and ensure that all members of the practice have reasonable expectations about what the EMR will do. If a provincial EMR program is available in your province, you may qualify for funding support either as a GP or specialist. The better prepared your practice is, the more likely you will be successful with your EHR implementation.
Is the EMR appropriate for your specialty? Not all EMR systems are designed to work well for every specialty. For example, ophthalmology-specific systems provide highly specialized functionality that is not appropriate or necessary in a primary care setting. There are a number of important considerations when selecting a specialty specific system, including:
- Templates that are designed to capture information specific to that specialty in a format and according to a workflow that is appropriate. Templates should be easily customizable by the clinician or practice.
- The ability to connect diagnostic devices directly to the EHR so that data from the devices can be automatically imported into a patient’s record, e.g. spirometry readings for respirologists or EKGs for cardiologists.
- For surgeons, schedule synchronization between the EMR and the hospital OR booking system. This is usually conducted through a third-party software; however, it is worthwhile checking with EMR vendors whether they offer this capability.
- Quality of consultation reports — review what a typical consultation report looks like to ensure that you are comfortable with the output and the format.
Is the EMR appropriate for your practice size? EMRs are generally designed for certain practice sizes. Systems that work well in practices of 1–3 physicians are not necessarily the right type of EMR for a larger multi-specialty practice of 25 or more. EMRs for large practices have to be able to support larger numbers of clinicians and staff working on the system (and sometimes the same patient record) simultaneously. More complex EMRs frequently are a higher cost as the hardware to support the system needs to be higher performance. Ask EMR vendors for information on the size of practice in which their software is typically used.
Ensure you receive sufficient training — Make sure that training is a key factor in your selection process. Some vendors skimp on training in order to reduce the purchase price of their software, but this can be a big mistake that will ultimately cost more in the long run. When you do your reference checks and site visits (with existing users of the EMR you are considering), ask physicians and staff how much training they received and what they would recommend as ideal for that product. Onsite training is preferable initially rather than online training, as you will have the opportunity to test and learn the software in the exact setting in which it will be used. However, even with comprehensive initial training, it is not possible to learn everything you need to know about your EMR. As a result, you should include follow-up training in your budget to learn how to use the more advanced functionality. Even with adequate training, getting the most out of an EHR means that you will need to practice as much as possible so that the commonly-used features become second nature.
Post implementation support — It is critical that you understand what is included in your contract in terms of post-implementation support and maintenance. You will need to know support levels offered by your EMR vendor and which level of support you need to ensure the ongoing operation of your practice. These are frequently spelled out for you through the provincial EMR programs such as PITO and OntarioMD. Confirm how frequently updates are typically released and your role in terms of installing them — this is not an issue if you purchase a cloud-based EMR system, as the updates are managed centrally by the vendor. Ask current users what their experience has been in relation to vendor availability and responsiveness to support requests as well their responsiveness to concerns and requests for enhancements.
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