How to Select an EHR

Everything you need to know about evaluating a selecting a new EHR for your organization

EMAR

Whether your agency is looking to switch from your current system or wants to know how to select an EHR for the first time, choosing the right software can be a challenging process. Carefully evaluating your agency’s needs and finding a system that supports your agency’s specific programs will set up your organization for success.

But with so many EHRs on the market, how do you choose the right one? This guide will position your organization to properly evaluate different EHRs and select the one that’s best for your agency.

Table of Contents

EMAR

Clarify Your Agency’s Needs

Define Your Goals

When choosing an electronic health record (EHR) system, it is important to consider the strategic goals of your organization. EHR systems are complex and can vary widely in terms of features, capabilities, and price. By aligning your selection criteria with the strategic goals of the organization, you can narrow down the field and choose a system that is best suited to your needs. 

For instance, if becoming a more integrated community partner is a strategic goal, you will need a system that can handle data exchange, integrations, and data modeling. If your organization’s strategic goal is to improve the quality of service it provides, you will need to select an EHR with the capability to capture and analyze the specific data points used when evaluating evidence-based care. By taking the time to assess your organization’s needs, you can choose an EHR system that will help you achieve your long-term goals.

Evaluate the Needs of Your Programs and Staff

Going deeper, you’ll want to outline the requirements of your specific programs and your staff. What assessments, billing types, forms, funding sources, and reports does your software system need to support? If your agency runs residential programs or community-based programs, you might need additional modules that can handle housing, transportation, and employment. Looking for software that is nimble enough to support your unique program and staff needs will enable your agency to run even more efficiently after implementing the new software. 

Identify Current Challenges

Next, it is important to understand the challenges your team experiences with your current software. These challenges could be in the areas of billing, staff management, audit and compliance, growth and scalability, or reputation and agency performance, among others. 

It is important to note which areas of the organization are impacted by these problems. This will give you a deeper understanding of your system needs and help you avoid repeating these mistakes. To assess the impact of your current software’s limitations, quantify the problems by sorting them into one of three categories: Time, Money, and Effort. This will help you prioritize the issues and choose a software that will address the most pressing concerns.

For example, you may have identified that billing is a challenge for your organization. This is a good starting point, but you will want to dive deeper into the nature of the billing challenge in order to choose the right solution. Connecting the specific challenge with the overarching problem could look something like this:

  • The time between service delivery and reimbursement is too long (Time problem)
  • There is potentially missing revenue from services delivered (Money problem)
  • It takes a tremendous amount of effort to compile billing information (Effort problem)

This will help you diagnose the true issues at hand and steer the software search in the right direction. It’s also good to note that it could be a mix of these, or even all three! Another important step would be to rank which challenge is the most important. By taking the time to carefully consider all of your options, you can make sure you choose the best software for your business.

Keep What’s Working

There is one other very important step to include in this part of the process. List what is working well with your current system. If you are thinking about moving from another EHR system, write down what is working well in that system to make sure that can be part of the new solution. If your organization is on paper or spreadsheets, list the safeguards in place that provide the checks and balances. You don’t want to solve one problem and create a new one!

Form an EHR Selection Team

Designating a specific team to lead the search for a new EHR is often the most effective way to proceed in the process. Since your software tool affects the work of so many people at your organization, it can be helpful to involve a diverse group of people from your clinical, billing, IT, and quality assurance teams. While every role within an organization does not necessarily need to be part of the team, it is important to make sure each function is accounted for.

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The representatives should be aware of the overall strategic goals of the organization as well as the specific needs within departments. If there are parts of the selection process that might require certain expertise consider bringing in specific roles to act as specialists, as needed.

Having different voices with equal influence is ideal for identifying a quality long-term solution. If one consideration dominates the selection process, you can end up with a system that doesn’t work for all parts of the organization. For example, if the billing team drives the decision-making, you could end up with a system that works well for billing but is lacking for other needs. It’s only a matter of time before that same organization sets out to select a new system because the clinical staff feels the software is a poor fit! Equitable representation from stakeholders across all departments encourages ‘buy-in’ and is key to selecting a system that will work well for the entire organization. 

Team Roles

C-Level Executive

Executive or C-level involvement is critical to a successful selection process. A member of your leadership team will offer strategic decision-making capabilities, and ensure that the software is aligned with the overall vision of the organization. The involvement of senior leadership also stresses the importance of the project to the organization. This role can build consensus, drive the project forward, and authorize the decisions at the end of the process. 

Clinical Director and/or Program Director

This role is key to understanding the services side of the organization and clinical workflows. The number of programmatic team members to include on the selection committee depends on  the number and diversity of your programs. Understanding the workflows and key data points will be helpful in determining if the system will work for the organization. These members will also be aware of what data points are critical for audit purposes. 

Quality Assurance

The head of Quality Assurance is typically one of the roles that does the most reporting in an agency. Pulling information and getting data out of your EHR is one of the benefits of using an electronic system, and understanding the reporting requirements of your organization is crucial. In addition, understanding outcome data and client quality assurance data can provide a strategic edge to the organization and leverage the full capabilities of the software.

End User(s)

Include at least one tech-savvy, highly engaged end user on your selection team. Understanding how end users will engage with the software can be helpful in determining the overall ease-of-use of the system. In addition, they can help to train other team members and promote overall adoption. Their insight on how the system helps, or in some cases may hinder, their work is invaluable to the process.

Billing

This is especially important if you are reviewing an EHR with an integrated billing system. However, even if you are planning on a separate billing system, it is important to have someone who understands where service data comes from and can provide a viewpoint on how it could impact the funding. If your organization doesn’t do billing, then including the person who does your grant writing or contracts is a good alternative.

Other Roles 

You can build out your selection team with other members you think will add value in the context of your organization. In particular, two extra roles that are worth considering are an IT Specialist and an EHR Implementation Specialist. Depending on the size of your organization these might be internal staff members or external consultants. 

IT Specialist

Although web-based software is not a traditional IT project, we recommend having your IT Manager weigh in on the selection process as they can ensure security requirements and data considerations are met. They can also provide insight on how the system will integrate with the existing IT setup. If your organization does not have a dedicated IT person on staff, this role can be filled by a third party.

EHR Implementation Specialist

This role corresponds with whoever will be leading the EHR implementation on your team. The EHR Manager can help to highlight core functionality requirements of the system, look at configurability options and how that might impact the rollout, and they can provide insight on training and implementation. If this role doesn’t exist in your organization, it can be combined with one of the roles above.

"We made it a priority to communicate with staff how important it was to make this transition, focusing on the ways the new system would ease everyone’s day-to-day work and move the organization forward in the long term."
Jane Pirsig
Executive Director,
Aurora Family Service
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Begin Your Research

With a clear understanding of the needs of your agency, and a robust selection team in place, it’s time to start researching which software will be the right fit for your organization. 

Understanding Different Types of Software

There are many different kinds of software out there and in many cases there are data collection points that will overlap. As you begin to research systems, you will notice that ‘Human Services Software’ comes in many different varieties. First off, here is a general overview of the different categories of software that you will encounter when thinking about service documentation.

Case Management Software

There is no ‘certification’ process to be a case management software system. The main function is just to capture notes and basic documentation. There may be some assessment functionality as well. 

Client Document System

A client document system has the features of a case management system, but includes individualized plans, such as  service / treatment / goal plans, and captures detailed client-specific information such as diagnosis, family information, employment information, etc. There may also be some clinical information. 

Electronic Health Record (EHR) or Electronic Medical Record (EMR)

An EHR or EMR has all the features of a case management system and client documentation system. They also include clinical and medical components such as medications and allergies. 

There is a certification process for EHRs and EMRs. Certified EHRs are required to store data in a structured format which allows health care providers to easily retrieve and transfer patient information to support patient care. EHRs are also required to have certain functionality.

Additional Features

Choosing the type of system you need becomes more complex when you include which additional features you require. These features may be part of the primary system, or may be offered through a third-party integration.

Here are some additional categories to consider when evaluating systems::  

Revenue Cycle Management (RCM)

These systems track and compile billing information. Typically billing is for Medicaid and other insurers, and some systems can bill counties, other providers, and individuals. 

Practice Management

These systems are typically what you think about in terms of front desk software. They cover scheduling, checking clients in, and they can assist with follow up, updating billing information and more.

Business Intelligence (BI) and Data Warehousing

These systems take reporting to the next level and allow for robust data analytics.

Staff Management

These systems track staff and payroll information. In some cases they may track certification and training for staff.

A good understanding of functionality you need will help to narrow down the field of options and allow you to focus on the systems that can solve your challenges. Map the features you want to the problems you are trying to address to thoroughly examine the market and find the best solution for your organization. Some systems may not have the feature you want, but can solve your challenge in a much better way. 

Finding Potential Vendors

Search Online

When thinking about how to select an EHR, comparing the options online is a good place to start. You can search for a software vendor that specializes in your agency’s programs and the population you serve. Or, if you’re a multi-service agency, you can select software that supports a variety of different service types.

Attend Industry Events

Industry events are a great way to meet vendors in person and learn more about their systems. Check out local conferences hosted by organizations relevant to your agency. With much of the world transitioning to virtual events, many conferences have set up virtual meet-and-greets with software vendors.

Ask for Referrals

You can ask agencies in your network for recommendations on different vendors and their experiences with their current systems.

Compare EHR Vendors

Programs and Region

A vendor that understands your agency’s programs will be best equipped to support you. Whether you run an I/DD, behavioral health, mental health, or HMIS agency, you should look for a vendor with experience in your particular sector and software that is flexible enough to meet your program needs. EHR software that is built for use with your particular programs will be best suited to meet your funding, documentation, reporting, and workflow requirements.

Also, search for vendors with a high-level of connectivity to other systems and a strong track record of successfully building these connections as new systems arise, particularly in your state or region. This will reduce the need for double-data entry, manual data uploads to your government/funder systems, and data entry errors.

Implementation and Support

Ask your prospective vendors to walk you through their full implementation process. A robust implementation plan includes configuring your software to your agency’s workflow, bringing in your forms and assessments, helping you transfer your existing data, and getting your staff ready to use the software.

Make sure you consider training and ongoing support after your implementation. Training is crucial to helping your staff feel confident and comfortable with any new tool. Training offerings range in scope: from online documentation to classroom-style courses. The ideal software vendor has a comprehensive library of help guides for those looking for information on their own, while still offering a robust, responsive help desk for anyone that needs further support.

As regulations are always changing, it’s important to select a partner that has long-term experience in keeping up with regulatory changes and adjusting the software to meet those requirements. Your software vendor should be proactive in communicating changes to you and training your staff on any potential adjustments to their workflow.

Manage the Decision-Making Process

As you move through the EHR selection process there are some key strategies that will help to streamline the decision-making process. Understanding change management techniques, communicating clearly internally and externally about the process, and setting realistic expectations are the key pillars of managing the decision making process.

There should be a clear understanding throughout the entire organization that adoption of the new EHR is a meaningful and necessary strategic change. This should tie back directly to the goals and challenges listed in Step 1. 

Stay accountable to the process. It helps to break the project into smaller milestones – for example: 

  • Challenges and goals identified
  • Selection team formed
  • Requirements document finalized
  • Vendor evaluation completed
  • Vendor selected 

Attaching dates to your milestones will help keep the project moving. It is common during an evaluation process to have unexpected outside events occur like audits or emergencies. Having defined deadlines will help overcome those challenges. 

Finally, celebrate the successes. As milestones are completed they should be celebrated within the organization. This will keep the EHR adoption process top-of-mind for the entire organization and will build excitement and buy-in. In turn, this will pave the way for a much smoother and more effective implementation process.

Selecting an EHR can be a daunting process, but done right, the benefits will far outweigh the work required to make it a success. This guide is intended to help you manage the selection process and achieve a successful outcome. Our team has helped many agencies transition to a new EHR and we would love to hear from you if you have thoughts, questions, or concerns as you embark on this journey.

Wherever you are in the process, our team can provide guidance on choosing the right EHR for your agency and your programs.