Selecting an EHR is not just about the demo. But those EHR vendors sure do put a lot of focus on that demo! You need to get beyond the smoke and mirrors and consider how to use that focus to evaluate the solution as it meets your needs and requirements.
Before you even schedule any vendor demonstrations, write down your "must haves." Can you identify your top 10 requirements?
For example, in one practice I work with, the system must track all pap smears for outstanding results and also automate notification to the patients of their result. In another, the EHR must incorporate a point-of-sale purchase of retail items. A 10-physician internal medicine practice required that their EHR solution incorporate voice recognition software to ease the transition for keyboard-phobic physicians.
Different specialties have different needs, and you should think of as many specialty-specific requirements as possible. Having an interface to the lab results for the bulk of your patients (75% to 80%) is an absolute requirement in primary care, for instance. Try asking yourself: What do I do that doctors in other specialties don't? Figure out how those differences would translate to functions in the EHR.
You can also incorporate the criteria that CMS will use to define Meaningful Use of an EHR for its incentive program to determine how your use of the EHR system will address specific objectives. (Even though the criteria are only in the interim final rule stage, wholesale changes don't usually happen past that point.)
For example, it is likely that collecting the smoking status on all patients ages 13 and older will be one of the objectives, so ask the EHR vendor to show you how their solution prompts you and/or your staff to ask the patient, document the response, and then generate the collective data for reporting.
Articulating your needs and requirements is just the first step for effective evaluation of system demonstrations.
The second step is to use those needs to create a scoring tool to track and document the EHR demonstration against the needs.
Keep the scoring simple. A 3-2-1 system will do just fine. The vendor scores a "3" for a specific need if the system exceeds your requirement, a "2" for meeting your requirements and a "1" if the system does not meet your requirements. The higher the vendor's score, the better fit the system is for your practice.
How does the scoring tool help after you've viewed three or four demonstrations? You can approach the comparison several ways.
The most basic -- though not necessarily the best -- way is to look at the total score for each product. High score wins and that's the one you buy.
Or you can compare the vendors on each "need" individually. Clearly if a vendor scored a "1" on each element, that product is a no-go. That's probably unlikely, though, so you'll need to prioritize your "needs." Again, the product that has the highest scores on the most number of top-priority elements is your winner.
It may also help to have a "deal-breaker" need. If a vendor scores a "1" on that one item, even if his system has "2"s and "3"s on all the others, you might want to rule it out.
You may also decide to include some "nice-to-have" features on your list. If so, scores on those items may tip the scale for one product over another.
It is easy to get distracted during a demo by all the features and functions the company representative will show you. Many systems have polished user interfaces and many demonstration specialists have perfected their skill at showing off the sizzle in their system.
But if you begin the demo preparation with the end in mind -- by clearly articulating your objectives and vision for your EHR implementation -- you will identify the solution that will have the greatest opportunity for successful use in your practice.
Focus on how the solution meets your requirements, not on the man behind the screen as you travel down the road to your EHR selection.
Sample score sheet
| Requirement | Score | Comments |
| Lab interface to XYZ lab for result delivery | ||
| Collection and reporting of meaningful use criteria | ||
| Test tracking and patient notification functionality | ||
| Etc. |
Score key: 3=Exceeds requirement 2=Meets requirement 1=Does not meet requirement