The Path to Paperless

Which EMR System Should I Buy?

Your practice priorities are key to that decision.

Since beginning this column about a year and a half ago, I have received numerous e-mails asking me which EMR system is the best one to buy.

The column has described the journey our practice has traveled in the process of going paperless, therefore I believe we have become somewhat knowledgeable regarding the “change management” process of bringing a new technology mindset into a paper-based culture.

But what we are not is an authority on EMR systems. Although we have reviewed several systems and were even involved in the early development of another system (which we ultimately did not choose), there are just too many variables involved in making one of the most significant decisions your practice must make. We now know what makes a bad EMR system, but there are many good EMR systems out there.

Make a Wish List

To help you in your decision-making process, ask yourself what you are trying to accomplish. Is it merely to become more efficient? Are you preparing for pay-for-performance, which will require you to have EMR? Are you running out of physical space for paper records? All of these were major factors for us.

After you decide why you need EMR, make a list of the features you must have and the ones that would be nice to have but that you could live without. Do you want to keep your existing electronic practice management (EPM) system or do you want an integrated EPM/EMR system?

System Flexibility

Many systems are ready to use “out of the box” with minimal customization. But often their ease of use may be offset by the degree to which they can be customized. This may result in the practice adapting to the workflow processes of the EMR system. These systems, which tend to be less expensive upfront, are better suited for a solo or small group practice that is not married to a set way of doing things.

Other systems are more robust in terms of flexibility and customization but may be somewhat intimidating for practices with limited technical know-how. They may require in-house information technology (IT) personnel or help from a local IT consultant. The trade-off is in the ability to adapt the EMR system to existing workflow processes. Many larger, well-established practices have developed efficiencies in their processes and find it preferable to change the way the EMR system works instead of vice-versa.

At the Academy or other ophthalmology meetings, make it a point to visit vendor exhibits and check out the various systems. Give them a test drive; have the representatives input your clinical information as you dictate it in real-time. Get names of practices as references.

In the end, we chose a system we could adapt to the way we practice. This has pushed back the time before we “go live” but we are confident that this will significantly increase our chances of a successful EMR implementation.

Next: Making your personal life paperless