August 7th, 2024 / News
Avoiding Surprises – Five Key Questions to Ask When Evaluating an EHR Vendor
With so much to consider, avoiding hidden and often astronomical costs is a top priority for healthcare leaders. Understanding the totality of an EHR vendor’s offering is crucial, especially since vendors do not cover all the costs of their solutions similarly.
Electronic Health Records (EHRs) are an essential component of the healthcare IT ecosystem as reflected by the continued growth of EHR expenditures throughout the United States. As a significant and long-term investment, hospital and health system leaders are understandably deliberate in the process of vetting, purchasing and transitioning their organizations to a new EHR.
With so much to consider, avoiding hidden and often astronomical costs is a top priority for healthcare leaders. Understanding the totality of an EHR vendor’s offering is crucial, especially since vendors do not cover all the costs of their solutions similarly. This can lead to confusion and uncertainty about what costs are included in a purchase contract. To combat this, there has been a paradigm shift towards seeking more transparent offerings, such as the comprehensive System as a Service model. This model includes all components of the implementation, hardware and software, and the utilization and maximization of the system. Here are five key questions to consider when heading into an EHR acquisition to maximize ROI, workflow continuity and overall success.
1. How transparent is the cost breakdown?
With budgetary constraints as daunting as ever, identifying the contract elements in their entirety is essential. A detailed account of all software, hardware and services components, including costs associated with data migration, staff augmentation, medical device interfaces and interoperability should be identified. Validate the scope of what is included for implementation, configuration and ongoing support services for upgrades, maintenance and enhancements. Determine any third-party costs for items not covered by the EHR vendor; consultants, data migration, integration, and specifically confirm if there are monthly service support limits and the cost for any services that fall outside of those parameters. Identify if your organization will be billed by volume or a fixed cost solution. Determine the total cost of ownership from contract signing to contract renewal.
2. Is the system adaptable and interoperable?
An architectural framework that conquers evolving challenges in interoperability, scalability, and real-time performance data is paramount to selecting a system. The system should provide a comprehensive longitudinal patient record that can cross multiple sites and environments seamlessly, adapting to changing data needs over time. Look for a system that can normalize disparate data sources for seamless interoperability that will meet your requirements for today and for future innovations.
3. How will it affect staffing?
It is common for organizations to underestimate the staff required not only to implement and manage their EHR implementation, but also for ongoing system management. With ongoing clinical and IT staffing challenges, it is important to have a clear understanding of a vendor’s staffing requirements and support services to meet the needs of your specific environment over the life of the contract. Will the new system offer a robust out of the box solution that can be customized? How will current clinical, administrative, and financial workflows be affected? Additionally, understanding the ease of use, configuration, and training approach early on is critical to mitigate change management challenges and potential impacts on productivity and clinical and revenue cycle processes. A rapid, efficient deployment leads to substantial cost savings and faster realization of benefits. Look for a reliable and integrated system that is intuitive and user friendly built by clinicians for clinicians with 24/7 end-user support to minimize initial and ongoing burden on clinical and IT staff. This drastically reduces the resources and time required from healthcare organizations to implement, train and support the system, allowing them to focus on strategic initiatives and patient care.
4. Is system and medical device integration included?
Data migration and integration among systems, devices and other technologies is a critical component and in some cost models can be an ‘add on’ in terms of expenditures. In order to meet interoperability standards and provide a true, real-time longitudinal patient record, it is critical to understand exactly what elements are included, if there are limitations around the EHR systems’ technology and what additional costs may be incurred to bridge those gaps. Just as important is to understand the costs of future integration. For example, if the organization decides to migrate to different medical devices or a different device vendor, such as for bedside or fetal monitoring, what downstream costs, if any, will be associated with this decision. Confirm that the EHR vendor does not put limitations on the hospital’s options.
5. How will operational disruptions be mitigated?
Not all EHRs require downtime to manage scheduled updates, security patches, upgrades and the like. A solution that delivers 100% uptime for maintenance and upgrades, as well as unplanned incidents, is one of the many factors that organizations should expect from their EHR vendor and need to evaluate fully in their decision-making process. Gone are the days of accepted and planned downtime on a weekly, monthly or quarterly basis. It is time to expect more. It is important to dig into the history of any EHR vendor to understand their experience to avoid clinical dissatisfaction, poor patient care and loss of funds.
Transparency is the key
Choosing an EHR system is a pivotal decision with far-reaching implications. Trust and transparency are paramount in fostering a successful relationship between the vendor and the hospital system. Healthcare organizations with a complete picture of the investment – both upfront and long-term – to include impact on staff satisfaction, workflows, and ultimately patient care, will have the most satisfactory outcomes throughout the EHR acquisition, implementation and utilization process. The vendor’s success should be defined by the hospital’s success, reflecting a true partnership where the vendor acts as an extension of and integrates seamlessly into the organizational team. Transparency from the outset, and exploring all options, such as the comprehensive system as a service model, will set the system up for success for years to come.
