- Is the product designed specifically for Pediatrics?
Pediatricians have special needs not found in other specialties. Kids are not small adults. In a Pediatric patient, there is a higher utilization/visit amount by the younger patients than the older patients. An EHR sales person will state that ‘we have a large amount of Pediatricians’ using our system. This does not mean the product is designed and easy to use for Pediatrics (might just mean that the company has a strong sales force). For example, a practice needs to verify the system has coding linked into the template for each of the well visits type. Is there an integrated vaccine management system as well scheduling logic based on Pediatrics? Does the organization understand “Denver Development” and “Bright Futures” and how to incorporate these approaches into their system?
- How easy is the system to use and can we customize?
Many EHR systems are set-up with small boxes with many commands to learn. Some systems appear to be “Excel-like” spreadsheets with difficult operational interfaces. These systems might have been designed an older technology for a number of reasons including: the cost is too high for the organization to start over, the CIO/staff does not have the skills in the new technology, the technology team is not well integrated with what the user needs. If you see the opening scene for the 2010 Wall Street Movie, Michael Douglass is given back his large phone from the 1980s that no one uses today. You would not by a cell phone made in the 1980s or 1990s, why would you purchase an EHR system built on the technology of the past? The system should be easy to learn. A demonstration of the system is a must. Ask a practice that adopted an EHR system you are interested in how the physician, nurse/MA, front desk like the system. Recommend you either call a physician partner about the system or if possible, spent a ½ day at a practice.
- Does the system receive lab results as data elements directly into the E.H.R.?
Some of the systems advertise that they have a method to record lab results in the EHR. There is a free EHR known as “Practice Fusion” which shows the EHR can accept a PDF file. This does not meet the requirements for meaningful use per the Health and Human Services Requirements. The real question to ask them is do they have an HL-7 interface with the ability to receive lab results directly into the EHR. If they can answer yes and show you an example in the demonstration, they have the ‘right’ lab interface.
- Does the system have direct connection to Surescripts for both sending electronic prescriptions as well as receiving messages on formulary status?
All electronic prescriptions are routed to the pharmacy via an organization established by the large Pharmacy Benefit Managers known as Surescripts. Surescripts will allow EHR/E-prescribing vendors to link directly to their system. To do this, a vendor needs to be able to build all the systems to appropriate route the prescription as well as receive refills. Surescripts can send formulary status of patients as well. Some organizations choose to not invest the resources (they might not have capable enough programmers or enough programmers) and time to build the formulary link. A ‘short-cut’ is for a vendor to use an e-prescribing vendor to help them so that the when a physician wants to receive a formulary message the message/request is sent from the EHR vendor (e.g. Dr. first). There are two ways to identify if a vendor does this, ask them and look on their web site to see if there are partnerships with Dr. First or similar organization.
For further questions to ask, please read article “What are some questions I should ask when looking for a Pediatric Electronic Health Record (Part 2 of 2)?”