Where's The Logic? How I Made My Decision - Part 1

So how did I make my final decision and what factors influenced my choice in purchasing an EHR?  First, I found it beneficial to find out exactly why I wanted an EHR. I decided to make a list and here is what I came up with:

Why use an EHR?

1. Government incentive
2. Increase efficiency
3. Eliminate missed billings
4. Increased (better) documentation ===> better reimbursement
5. Less Paper ====> Paperless
6. Ease of documentation - less time on dictation - leave office earlier
7. Better patient care.
8. Make things easier, run smoother. Less time tracking down charts.

The following tasks to be eliminated:
1. Preparing paper chart folders for new patients
2. Pulling charts for former patients
3. Adding stickers to charts (date, allergy, medical alerts)
4. Printing out dictation and sticking in charts
5. Re-filing charts
6. Entering charges using superbills

Now that I know why I want an EHR, it's time to investigate. First, I did a significant amount of online research. I am a very visual person and I wanted to see what each EHR program looked like. Unfortunately, many companies do not provide screen shots or videos of their programs unless you fill out a contact form which gives them permission to continually hound you with sales calls and emails. As a side note - I am trying to change the lack of available online visual material with this blog and am contributing as many videos and screen shots as possible showing different EHR's at work and am encouraging my readers to contact me so I can help them create their own videos of their EHR.

Of course some companies do have videos online and a quick search of YouTube.com and Vimeo.com using the EHR's name is a good start. Also, using Google and clicking on "Images" on the left side of the browser will take you directly to some of the available screen shots.

After completing my online research, I narrowed my selections and made direct contact with companies to provide me with an online demo of their product. In an upcoming post I will discuss the pitfalls of doing an online demo as well as what to ask the rep doing the demo, but for now I'll just concentrate on the process I used. But before I do, let me tell you about...

Practice Fusion

I actually used Practice Fusion for my ePrescribing while I was still using paper charts. It was free, easy to use, and helped me meet the Medicare ePrescribe requirements to avoid penalties. I tried the EHR but found it too limiting for my use. If your charting needs are simple, you may be good to go. By all means you might as well try it, after all it's free. But for me, I just couldn't get past the limitations. In addition, I like to take a lot of clinical photos and incorporate them into my charting and Practice Fusion just didn't make this easy enough for me. I also wasn't thrilled about having to upload every photo I took or every document I scanned. So that is why you don't see Practice Fusion in the spreadsheet below, but I certainly gave it a good look and a trial as should you.

The Spreadsheet

I built two different spreadsheets. The first, a cost analysis and the second a breakdown of pro’s and con’s of various systems. 

Spreadsheet #1 - Cost

For the spreadsheets, I narrowed my EHR choices down to six different programs. This was down from my initial search in which I chose 10 to investigate further and then narrowed it down to eight serious contenders. From those eight, I cut it down to six, deciding one was just too high-priced and another was just too complicated (the screens were very complex and just way too much going on in the program for my needs).

In the following spreadsheet, I examine the costs of four web-based systems and two that use in-office servers. This is a cost breakdown based on figures and quotes directly from the company reps. These costs included software and training costs for the web-based systems and includes software, training and hardware costs for the server-based systems only. (The web-based system costs assume no new hardware will be purchased). One note: the server-based figures do not reflect the fact that the server will need periodic replacing (or upgrading) which would add about another $2500 to the cost every 5 years or so. As it turned out, I was able to negotiate a significantly much better deal for software and training then I was given initially, but these figures would give me a fairly good idea as to the cost. I felt it was important for me to look not only at the initial cost, but also to calculate total cost after 5, 7 and 10 years. This would allow me to get a feel for how the EHR would impact me financially. While this should not be the main factor in choosing an EHR, it should be given careful consideration as should anything that will affect your bottom line. Here is what my spreadsheet looked like:

As you can see, while the initial cost for a web-based system is low, the long-term costs are quite high. This, along with the second spreadsheet (coming-up in a future post ) helped me make my decision.

Coming up Next: "Let's Peek Under The Hood"