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Shopping for EHRs and Technology at Your Practice

Shopping for EHRs and Technology at Your Practice

Shawn Harkey, who recently led his multi-location subspecialty ophthalmology practice's search for a data clearinghouse, has the art of comparison shopping for technology down to three short weeks.

But that doesn't mean Dallas-based Texas Retina's director of finance, who's regularly tasked with making large corporate purchases, thinks the process of tech shopping is easy.

"We hadn't looked at clearinghouse products for over three years, so we were essentially starting from scratch," says Harkey, whose 17-provider practice selected Navicure's clearinghouse product after looking at three vendors. "In the initial search, one of the biggest challenges was truly being able to compare one product to another and reviewing all of the new offerings from each clearinghouse vendor."

Fortunately Harkey's practice emerged with a product that staff are fairly happy with. But other practices aren't always so lucky, whether it's a clearinghouse, EHR, patient portal, or some other technology purchase.

In the Physicians Practice 2012 Technology Survey, Sponsored by AT&T, of nearly 1,400 practice administrators, physicians, and healthcare workers, for example, 12 percent of respondents said they were either "dissatisfied" or "very dissatisfied" with their EHR; and nearly one-third classified their EHR as "mediocre." And that question doesn't even include all of the other technology your practice probably uses, such as a practice management system or claims-processing software.

No matter how much shopping you've done in the past, making selections for your practice is an especially high-pressure task, considering the high cost of technology, or worse, the high cost of implementing the wrong technology. If cost weren't enough of a stressor, there are hundreds of practice-management systems, EHRs, data clearinghouses, patient portals, and other electronic products and services to choose from.

But with the right strategy in place you'll avoid getting ripped off or experiencing buyer's remorse. Here's the lowdown on how to shop, start to finish, for new technology.

Start with a needs assessment

Whether you're shopping for recipe ingredients, a new coat, or an EHR, there's a danger in buying the wrong thing if you don't know what you need first.

"A lot of people go out and they haven't got a clue of what they need to buy," says Beverley Caddigan, a Brooklyn, N.Y.-based healthcare IT and business consultant. "If you're going into a semi-virtual environment, do you need a thin client? If you need an EHR, for example, can you make do with one of the free ones out there or do you need to buy one with all the bells and whistles? How many users are you going to have? How much equipment are you going to need to have?"

Laura DeBusk, a healthcare consultant and senior director of business development for Birmingham, Ala.-based White Plume Technologies, says practices might have an easier time figuring out what they need by using a "tree of decision making." In doing this, a practice asks itself basic, broad questions that get more and more specific as it narrows the choices.

DeBusk offers the example of a practice shopping for an EHR. First, the practice might want to ask itself, "Do we want a server in the office or a cloud-based application?" Once that decision is reached, the practice might ask, "What devices do my providers want to use?" to narrow down the options even further. Then, the practice might want to address interoperability, asking itself, "What other systems and data do we need to connect with?" And finally, the practice would want to examine work flow issues, such as how patients make appointments, or how the practice works with referrals, authorizations, and orders.

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