Continued from Part 1 of 2, listed below are some additional questions to consider when selecting a Pediatric EHR.
- Can broadcasting (via e-mail/voice) be done easily with the EHR System?
Pediatric groups have many needs for sending our broad cast messages. Examples include: announcement of a flu/H1N1 clinic, change in hours (e.g. summer hours), announcing a new provider. There should be a field for the staff to collect e-mail so that an e-mail announcement can be sent to all families whom provided an e-mail address. Does the system have the capability to send out the e-mail for no cost to the practice or does the list need to be loaded into another system/company that adds cost to the practice? For voice broadcasts, the practice should be able to download a list of the primary phone number and export to provide voice broad cast messaging. A direct link only to one vendor is usually not the best financial interest to the practice. For example, a cloud based voice broadcast company called ifbyphone has some very inexpensive options for voice broadcast; they have no contracts, a small monthly fee that can be cancelled at any time.
- Does the system have a balance in quality between the EHR and practice management/billing?
This is important. Some systems built an EHR because they want to maintain their practice management clients. If this is the case, how easy is the EHR to use? What is the cost? Does the system have complete integration? Others built an EHR with minimal knowledge of practice management and billing. There is extra cost and work for transitioning data between two systems. This can occur in a practice when the practice management do not want to change and ‘force’ the EHR on the providers or the other way around – the providers find an EHR they like to chart with but the system is ‘weak’ on practice management. A good indicator of this lack of balance is on a company’s web site. When you see that there are many links/alliances with EHR Systems, they probably have a very weak EHR but a solid background in practice management. When you see an alliance with a practice management company (e.g. Athena Health, Physicians Computer Company), usually a good indicator that they have weak practice management system.
What are the total costs?
It is extremely important to compare total cost. When evaluating a system built on client server technology, make sure to obtain cost for maintaining the server and backup. Servers have a life span of a number of years (some use 4-6 years). Evaluate current costs, maintenance, reoccurring costs, set-up costs. The system adopted should reduce total costs for the practice.
- How up to date is the company and their systems?
Some companies have been around for years and unfortunately have not changed their technology for years. Being locked into Microsoft technology was an asset in the 1990s while today, I believe, it is a liability. When the internet was young, client server was the most appropriate choice. There are many draw backs with maintaining a server – software that needs to be updated on each server (this is how things go out of date), cost to maintain the server, time spent on the server, need for VPN when there are multiple offices. Using a system build on “cloud computing” means your practice usually has an IT team with degrees and experience in Systems and Engineering and/or Computer Science maintaining backups, data and software means that the office only needs to maintain a connection to the internet. I use the word ‘usually’ because one of our competitors has a CIO without a Computer Science Degree or an Engineering or Systems Engineering Degree (unsure if he ever graduated from College). If a practice uses a system built on cloud computing, the practice can use low-cost IT support like “The geek squad” to maintain the internet connection as well as computer set-up. Does the technology easily allow a physician to pull up charts on the iPad, mobile phones? It is either very difficult or can’t be done for an EHR system built on ‘old technology’ to be usable across these different platforms. Other costs to consider: training, e-prescriptions, interfaces with Lab companies, reporting/practice management, cost to customize. Note: our CIO has 8 years of programming experience and a degree in Computer Science.
