To get started toward a successful acquisition, you first must understand what are your requirements for an EHR, including:
Other organizations can advise you about the process for selecting and obtaining shared EHR and health information exchange technology. View the Organizations You Can Collaborate With section for more information about locating and working with nearby Health Center Controlled Networks, Regional Extension Centers, or your State Health IT offices.
After completing the planning process, you will want to better understand the range and quality of services available from the individual vendors. Find out more about them by reviewing their past performance and determining the length of time they have been providing services to practice settings such as yours. You can collect this information by talking with the vendor and asking other safety net providers about their experiences.
Contact local safety net providers that use EHRs. Find out which EHR vendor your peers are using and see if you can try out their systems. Find out whether they contracted directly with the vendor, or worked through a network and ask about their experience implementing and using the system so far.
Start by asking these questions:
Interview Certified EHR vendors. Using information you collect about vendors, you can begin to narrow the field of ones you want to consider seriously. In doing so, check to ensure that those on your list also are on the Office of the National Health Coordinator for Health IT site listing Certified Health IT EHR Products.
Contact selected vendors to set up a phone interview. In the discussion, ask these questions:
Arrange for vendor demonstrations. After further narrowing the list based on initial interviews, schedule demonstrations with a few of the most likely candidates. For best results, provide patient and office scenarios that the vendor may use to customize their product demonstration. Schedule enough time to thoroughly test out and discuss their product. Invite as many staff members as you can to build buy-in for the EHR project.
During the demonstration, check out these features:
Ask for general cost information. Vendors provide final cost estimates as part of their proposals, but you can ask for general information or cost ranges for:
Select your top three to four vendors and request proposals from them. Requesting more will require a complex proposal evaluation effort. Fewer will not provide enough information for comparison.
Follow these steps in developing your request for proposal (RFP):
Remember that the contracting process is governed by rules to protect both you and the vendor.
View a Request for Proposal (RFP) Template for HIT, which will walk you through this process and ensure that you adhere to the legal requirements.
Below are recommended steps for selecting the best proposal:
Use contracting tools to help you make the best choice for your needs and budget. These tools include:
After selecting a vendor, the next step is to negotiate costs and contract terms. Ask whether as a safety net provider, your organization might be eligible for discounts. Think about whether there are other negotiating points. For example are there several other providers in the area considering using the same system that might make it less costly for the vendor to offer training or assistance.
Use Contracting Guidelines and Checklist for Electronic Health Record (EHR) Vendor Selection as a tool in this process. It walks you through the contracting process plus offers tips on getting ready for and carrying out negotiations, obtaining approvals, and preparing the final document for signature.
Find organizations you can collaborate with, including a Health Center Controlled Network, Regional Extension Center, or State Health IT Office. They can assist you with contracting or connect you with other safety net providers considering system adoption to help negotiate cost savings through group purchasing power.
After the EHR contract is in place, the vendor will work with you to develop an implementation plan. The plan should describe how you will migrate your patient records (paper or files from an old EHR) into the new system. It should specify how to phase in the various EHR functions to minimize downtime and disruption in patient care. This plan also will include steps for installing the system and conducting staff training.
After launch, you will continue to work with your vendor to fine tune the system based on users’ needs and the day-to-day impact of the EHR on workflow. You also will need your vendor for system maintenance. It will be helpful to designate a primary vendor contact and back up contacts and to insert language in the vendor contract that specifies required turnaround time for response to requests.
Work with your vendor to develop a Disaster Recovery plan for dealing with system malfunctions or failures. You also should expect the vendor to provide immediate response in these situations and to offer on-site assistance during start up. If you do not find your vendor responsive, consider joining with other local providers who use that vendor to advocate together for more attention.
Over time, you may choose to add new features to your EHR, such as interfaces that will let you exchange health information with other providers and your patients. Making these changes to your original contract may not be the most cost effective approach. In some cases, it can be more economical to switch vendors.