How to select an EMR: 8 things to know when evaluating different EMR systems

Selecting and implementing a new electronic medical record (EMR) system can make a significant impact on an independent healthcare practice, offering a broad range of long-term benefits. Research shows that EMRs help keep clinicians organized, minimize documentation errors, enhance provider-patient communication, reduce wait times, and more.

However, choosing the right EMR system for your unique business is critical to ensure that the impact is positive. If your EMR medical software doesn’t suit your practice’s unique needs, you may not experience all the benefits. The wrong system could interfere with practice workflows, affecting clinicians, administrative staff, and patients — and potentially damaging your business's health.

That puts extra pressure on decision-makers who may already feel unsure about how to select an EMR system. Understanding the different types of electronic records platforms and their array of features and options can add to the confusion. The broad range of vendors in the EMR space makes the choice seem even more complex.

Most busy healthcare professionals don’t have time to sort through a mountain of information to identify the best EMR software. Fortunately, there are steps you can take to help put things in perspective. The following suggestions can help you prepare for the EMR evaluation process and empower you with information so you can choose wisely when the time comes.

Before you do anything else, know what kind of system you need. EHRs, EMRs, and practice management software are similar, but they’re separate solutions.

EMRs are digital records that contain the same personal, health, and medical information as paper charts. They’re typically used within a single practice. Traditionally, EMR medical software could only communicate within the home network.

However, some developers now offer cloud-based EMR platforms with varying levels of interoperability. These systems can communicate with outside entities, such as labs, pharmacies, or designated specialists. 

Larger clinics, hospitals, and health systems generally use electronic health records (EHRs). EHRs support coordinated care by making comprehensive health data available across numerous care providers and healthcare organizations. They contain patient information, medical history, and multi-provider notes and may also include AI insights or population health data.

While EMRs and EHRs focus primarily on clinical data, practice management software streamlines business-related aspects of a healthcare practice, such as scheduling and billing.  Advanced practice management software can integrate with EMRs and EHRs, automating clinical, financial, and administrative data-sharing and communication. 

Independent practices tend to have more unique requirements than large-scale healthcare entities. Understanding standard EMR options can help you prioritize features that suit your practice. 

Customization refers to optional features designed for a specific purpose.

Examples of customizable features include:

Some software companies also offer bespoke customization, meaning they can write a one-of-a-kind program for your business. Customizations should support the unique needs and workflows of your practice while ensuring the system is easy to navigate for all staff members. You can ask the vendor to remove features that are not relevant to your practice to reduce complexity and improve efficiency. 

Scalability means EMR medical software can accommodate changing needs as your practice grows. This feature keeps costs down for smaller practices with basic EMR needs, but can easily add new features when needed, such as multi-specialty support, comprehensive analytics, or telemedicine. 

A scalable EMR platform is crucial for growing practices because it can support an expanding data load without requiring a major system overhaul. As staff and patient panels increase, scalability helps maintain efficiency and streamlines new workflows while avoiding operational disruptions. 

Interoperability allows separate organizations to access and modify EMR records. An interoperable EMR platform enables information sharing and collaboration across multiple providers and facilities, supporting coordinated care and comprehensive health management.

Integration involves linking separate software systems for data exchange. Internal integrations (clinical records related to billing, scheduling, etc.) simplify practice workflows. External integrations (labs, imaging centers, pharmacies) accelerate prescription processing and allow imaging and test results to be uploaded directly into a patient’s EMR.  

Keeping patient data safe and secure is essential. The Health Insurance Portability and Accountability Act (HIPAA) requires EMRs to use unique user IDs and strong passwords and have controls that limit user access. 

Additional important security features include:

A robust platform incorporating these features helps ensure your practice maintains HIPAA compliance and patient confidentiality.

The user interface directly affects the efficiency of an EMR system. A clunky, complicated interface may impede the same workflows it’s supposed to improve. 

An intuitive interface, however, simplifies record retrieval and data entry, boosting efficiency. A well-designed interface that’s easy to navigate can enhance user satisfaction across departments. 

Comprehensive support is vital to maximize the benefits of EMRs. Vendor contracts should include robust training services to ensure staff know how to use EMR systems. Product support services should be ongoing, readily available, and easily accessible.

Independent practices vary significantly in size, specialty, demographics, and operational processes. Examining how these factors shape your workflows helps you decide how to select an EMR system. It also protects you from paying for unnecessary features or investing in a system that lacks mission-critical functions. 

Identify your current practice size and future growth ambitions to guide choices around functional complexity, scalability, integration capabilities, customization, and budget. 

Different specialties have specific tools, workflows, and protocols. These factors determine needs around record keeping, patient management, integration, and more. 

Here are considerations for specialty practitioners: 

Cardiology practices require reliable integration with electrocardiograms (ECGs) and other cardiovascular testing equipment. Patient records must contain complex image files from echocardiograms and other imaging technologies. Pre-loaded templates should support detailed risk assessments and long-term patient monitoring. 

Dermatology EMR systems should integrate with dermatological imaging equipment and be capable of uploading, viewing, and storing high-resolution images of skin conditions. The system should also provide tools for mapping lesions, documenting procedures, and adding notes directly to images.

Psychiatry practices need EMR software with extra confidentiality and security features. Digital records should accommodate extensive treatment notes and patient histories, facilitate prescription refills, and support medication adherence monitoring. Integration with practice scheduling is a must for regular follow-up appointments.

Many smaller practices benefit from plug-and-play EMR solutions with general healthcare workflow presets. Specialists and practices with unique workflows typically require more customized software to accommodate specific operational protocols and patient record-keeping requirements.

Likewise, smaller practices may only need internal and basic external integrations, such as labs and e-prescribing. Midsize businesses and those that use advanced diagnostic equipment or interact with larger healthcare systems will need more robust external integrations.

Evaluating existing infrastructure ensures EMR system compatibility and optimal functionality. Assess all hardware, including servers, computers, and network equipment, and verify that your internet bandwidth supports EMR integrations. Any needed upgrades will factor into your cost comparison process later on.

Digital patient records are subject to HIPAA regulations, which protect digital patient information and ensure electronic records software meets functionality and security standards. Unfortunately, it can be difficult to tell for sure if a particular platform is compliant. It’s essential to ask potential vendors directly about their compliance with HIPAA and other regulations to ensure your practice’s data is secure and meets all legal requirements. 

Keep these EMR regulations in mind:

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) security rule outlines administrative, physical, and technical protocols that ensure the security and confidentiality of electronic health information. Following these protocols keeps electronic information compliant with the HIPAA privacy rule.

The Health Information Technology for Economic and Clinical Health (HITECH) Act strengthens government enforcement of the HIPAA security rule and outlines stricter security and notification requirements for healthcare organizations. It also promotes the meaningful use of EMR systems to enhance care quality. 

The 21st Century Cures Act also strengthens the HIPAA security rule by setting requirements for health IT software developers. It mandates that health IT systems support seamless data exchange and facilitate secure access to protected health information for both providers and patients. 

The United States Office of the National Coordinator for Health Information Technology (ONC)  certification program involves rigorous testing to ensure that EMR software meets specific data sharing and interoperability standards in compliance with HIPAA requirements. 

Practices receiving Medicare and Medicaid reimbursements are legally required to use ONC-certified EMR software. However, an ONC-certified system ensures that any practice remains in compliance. 

Successful EMR selection depends on the ability to make meaningful cost comparisons between products. 

EMR vendors typically offer 2 pricing models: subscription-based or one-time payment. To understand the financial implications of each, consider factors such as available capital, monthly cash flow, scalability/customization requirements, and your current tech infrastructure.

Remember that the initial cost of a new EMR system goes beyond the price tag. Factor in implementation expenses, such as purchasing new hardware, migrating data from an older system, and extra compensation for the implementation team. Don’t forget ongoing costs, including tech support, maintenance, and software updates.

When evaluating ROI, you need to determine the total cost of ownership (TCO). It’s essential that your TCO figure is as accurate as possible. To calculate TCO, you should add all expenses associated with ownership. That means looking into the details and taking time to quantify soft costs. These are indirect expenses related to owning and maintaining the new technology, such as the cost of downtime or temporary inefficiencies due to implementation. 

It also involves factoring any cost savings related to the EMR technology into the final TCO number, including soft savings, such as faster information retrieval, related to the new EMR system.

Include costs such as:

Subtract cost-savings such as:

Remember that savings and benefits typically increase as the software fully integrates into practice operations.

A user's firsthand experience offers valuable insight into how an EMR system functions under real-world conditions. First, compare multiple online product reviews and note common issues, complaints, or praise. Online forums, where users can post and discuss products, may give you a deeper understanding of specific concerns. 

Speak to any colleagues who use the product in question. If your peers can’t help, consider reaching out to industry associations. There may be industry publications with detailed reviews, or the organization may put you in touch with another user.

Keep a running list of strengths and weaknesses as defined by other users. Seek out both negative and positive reviews and feedback. When possible, identify whether the user’s EMR needs are similar to your practice.

You’ve completed your research and prep work. It’s time to start the decision-making process. Use the following strategy to narrow your choices and prepare to cross the finish line.

Create a shortlist:

Reach out to EMR vendors:

Finalize the agreement:

Once you’re comfortable with the contract, have a legal expert look it over before you sign.

Develop a comprehensive, practice-wide plan to ensure a smooth transition to the new system. Schedule plenty of training sessions so your team learns how to use EMR systems. Plan for any hardware upgrades and prepare your team for data migration. Planning ahead can avoid excessive loss of time and revenue during the transition. 

Do remember, however, that change isn’t always easy. Be patient with your team, encourage communication, and respond to questions and concerns as quickly as possible. It's worth spending a little time and enduring a few growing pains in order to bring the best EMR software to your practice.

Tebra’s cloud-based, ONC-certified electronic record software lets you access patient files from anywhere, make notes, pull lab results, e-prescribe, and more. It integrates seamlessly with Tebra’s practice management software to provide a comprehensive, automated solution that transforms workflows. Read our practice automation guide for detailed information about how automation can energize your business.