"So, which electronic medical records system should I buy?" Since beginning to write on this topic about sixteen months ago, I've received many emails which ask this question. In response, I've tried to accurately describe the path our practice traveled in the experience of going paperless. I feel we've become knowledgeable in bringing the mindset of new technology to a paper-based culture. This is known as 'change management.'
However we are not an authority on electronic medical records (EMR) systems. We have reviewed some EMR systems in our process, even participating in early developments with another system. There are simply too many variables to consider when making this important decision for your practice. This may be the most important decision your practice will make, except hiring on a new partner. We have an understanding of what makes the difference between a bad and a good EMR system, but there are plenty of good EMR systems available that we are unfamiliar with.
To assist with your decision-making, you can ask yourself what you aim to accomplish. Do you simply want to become more efficient? Are you anticipating pay-for-performance evaluations which will require that you use EMR? Is it that you're almost out of physical space to store your paper records? These are all major factors in our decision to switch.
My next recommendation would be that you create a wish list of desired features. Start with those that you need to have, then adding those that would be nice to have but are not critical. You should discover if you would like to keep your current practice management system or create an integrated EPM/EMR system.
A variety of systems are able to be used 'out of the box,' with only minor customization. There's a trade-off: often ease of use is offset by the degree to which it can be made customized. This type of system is usually less expensive up-front, preferred by smaller-sized practices or those with limited resources.
Systems which are more robust, flexible, and customizable could be a bit daunting for practices with limited technical savvy. Working with these systems may require in-house IT to gain additional help from a local consultant. The trade-off here: the ability to adapt the system to the practice's existing workflow and processes. Larger, well-established practices with time-developed efficiencies in processes may prefer to change the EMR system's function instead of the other way around.
Attend Academy and ASCRS functions. At times they'll have one-on-one competition between top vendors, with a live audience present. Just go to the vendors' exhibits to examine the various systems. Take a test spin; the company rep will input your information as you dictate, real-time. Have some practice names to use as reference, even if not specifically ophthalmology practices (though preferred).
We selected NextGen's integrated EPM/EMR system in the end. Our staff views this system as a development tool, and we've been changing the way the application works so it molds to the ways at our practice. This has resulted in more work for us, pushing back the 'go live' date. We are confident that this will play a favorable role in a successful EMR implementation.
