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Transitioning to a new Electronic Health Record (EHR) system involves several key steps to ensure a smooth and effective shift. Here's an overview:

Assess practice needs

Begin by evaluating your practice's requirements and workflow. Determine which EHR features are crucial for your operations and how the new system aligns with your future plans. Set specific and measurable goals that will help evaluate the success of your project and to which you can hold the vendors accountable.

Engage stakeholders

Involve essential stakeholders, including physicians, nurses, IT staff, and administrators. Gather their insights on current pain points and desired improvements. Many of these stakeholders will have frequent responsibilities to the project so assure that they have time allotted for this role.

Research vendors

Thoroughly research EHR vendors that cater to ambulatory medical practices. Consider their reputation within your specialty and region. Pay attention to features offered, usability, scalability, and customer reviews. Compile a shortlist of potential vendors.

Prepare RFP

Develop a comprehensive Request for Proposals (RFP) outlining your practice's requirements and expectations. Request personalized demos from the shortlisted vendors to see how well their systems suit your needs.

Analyze costs

Obtain detailed pricing information from vendors, encompassing licensing, implementation, training, and ongoing support costs. Factor in the total cost of ownership over the system's lifespan. Understand the differences between professional licenses and Software as a Service (SaaS) agreements to make an informed choice. Remember that you will typically have ongoing costs for maintenance and support, which can range from 10% to 25% of the initial software licensing fees per year.

Assess data migration

Discuss data migration strategies with the chosen vendor. Inquire about their plans to maintain data integrity during the transfer from your current system. Ensure compatibility with other systems your practice relies on to maintain a seamless workflow.

Explore customization

Investigate the EHR's customization options. Inquire about creating templates for different patient encounters, adapting user interfaces, and designing custom reports.

Plan training and support

Evaluate the vendor's training offerings to equip your staff with the necessary skills to use the new EHR effectively. Inquire about remote and on-site training sessions, and ongoing learning resources. Prompt and reliable customer support is essential.

Evaluate security

Scrutinize the vendor's data security measures and disaster recovery plans. Understand how they safeguard sensitive patient information from unauthorized access. Inquire about certifications of their data security practices and protocols for data recovery in case of emergencies.

Review legal contracts

Collaborate with your legal team to review the contract terms. Negotiate with the vendor if necessary and address any third-party software contracts required for system operation. Ensure mutual acceptance of the contract terms.

Plan for implementation

Coordinate closely with the vendor's implementation team to ensure a seamless transition. Request a detailed implementation plan, maintaining the originally stated goals as your north star in devising system workflows. Conduct thorough user acceptance testing (UAT) to verify that the new EHR meets your practice's needs.

Monitor and adapt

Monitor the transition closely and address any challenges promptly. Plan the go-live carefully, considering support availability and patient load. Hold regular reviews with staff to identify and resolve issues. Provide feedback to the vendor based on your experience.

Engage as a partner

Maintain open communication with the chosen vendor throughout the process. Consider them a partner in your practice's success.

How do I budget for an EHR?

To determine a budget for your new EHR system, start by gaining a better understanding of the cost of your current system, as both a yearly cost and total cost of ownership over a set time period. Analyze your organization's current financial status, including cash flow, reserves, and available funds. Determine how much you can allocate to the EHR project without compromising other essential operations.

Best practices for budgeting for an EHR

  • Consider the cost of depreciation on equipment—servers, computers, and peripheral devices.
  • Remember to factor in recurring costs of licensing your EHR software, as well as what you pay for IT support and system maintenance.
  • Balance cost against potential ROI.
  • When budgeting for the new EHR system, in addition to the costs for software and hardware (or cloud-based hosting, if you select that option), you will need to factor in costs for implementation assistance, training, and data conversions, as part of onboarding to the new system.
  • If your new EHR platform allows for greater integration and configuration, you will likely save on labor costs.

How much should I pay for an EHR?

While it may be tempting to opt for the lowest-cost EHR, consider the long-term return on investment. A more expensive system with robust features and excellent support may provide better value over time.

It's important to obtain detailed quotes from EHR vendors and work with them to understand the total cost of ownership over the life of the system. Additionally, consider factors such as the vendor's reputation, user reviews, and the EHR's ability to meet your specific needs and scalability requirements.

Pricing range for an EHR

Providing a specific number or range for the cost of an Electronic Health Record (EHR) system is challenging due to the wide variability in factors that influence the cost.

Many EHR software licensing fees are charged per provider per year. For a smaller practice with one or two providers, this number would be much lower than for a larger healthcare organization.

Small-medium practices should look to spend between $50,000 and $150,000 for implementation and the first year of operation, while large healthcare organizations are looking at millions of dollars.

In summary, the cost of an EHR can vary widely, and there is no one-size-fits-all answer. It's crucial to assess your organization's needs, obtain quotes from multiple vendors, and create a budget that takes into account all relevant costs and factors. Remember, this is an investment in your organization's future, and while pricing may feel daunting, the right EHR choice can make all the difference.

Should I switch EHRs?

Deciding whether it is time to make the big EHR switch is no quick decision. Read on to see if it is time for your practice to take a leap and explore another EHR vendor.

Pain points

Are you noticing any of these common health IT pain points at your practice?

  • The system is thwarting rather than supporting your clinical and financial goals
  • Integration issues with other software or EHR/PM systems
  • Missing EHR functionality
  • Challenges in staying current with regulatory and reporting requirements
  • Software usability issues (slow speed, too difficult to use)
  • EHR software does not work on mobile devices
  • EHR is not configurable or built for your specialty
  • Dissatisfied with the type of systems architecture (web-based or client server)
  • Software vendor not helpful
  • Lack of scalability to expand or adjust according to business initiatives

Time to take action

If these pain points resonated with you, it may be time to switch. Don’t worry, we outlined the research process below:

  • Assemble a team to guide the selection process with representation from major areas of your organization and at various clinical levels. Include no more than seven members to make decision making easier.
  • The selection team should meet to build consensus on which capabilities of a new EHR platform are most important to the practice. Next, choose at least four vendors that may meet needs identified by your team.
  • Watch demos online to preview each of the identified products. During the demos, each person should note the features they like and rank them, based on how they'd help your practice.
  • Based on your research, finalize your list of key features and functions. The final list will help produce a more solid RFP. It will also help you gauge the overall market.

All of this is important in deciding if it is time for a new EHR.

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Roy Gill Headshot

Roy Gill, MD, FAMIA

VP, Clinical Affairs and Patient Safety at NextGen Healthcare

I joined NextGen in 2009, working first as a Physician Consultant, Director of Clinical Content under the Chief Medical Officer, and now as Vice President of Clinical Affairs and Patient Safety. A Family Physician by training with nearly 20 year of practice experience, I became interested in Clinical Informatics (CI) in the late 1990's as my institution was adopting an EHR. I became a Physician Champion and began to dive even deeper into Informatics. I eventually earned a Graduate Certificate in CI from Oregon Health and Science University and became Board Certified in CI in 2015 (as well as earning a Six Sigma Black Belt somewhere along the way). It's an exciting time to be working at NextGen, as we vastly improve attention to improving outcomes, patient safety, client needs, quality, and the evolving needs of our clinicians and the industry.