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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Information Technology

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Select a Certified EHR

How to Select a Certified EHR

Consider following these steps to make the best EHR choice for your organization:

Assess Your Requirements

To get started toward a successful acquisition, you first must understand what are your requirements for an EHR, including:

  • Open source or off-the shelf commercial software
  • EHR functions such as patient demographic and care management data on patient visits
  • Clinical decision support, and  reports
  • Consents, authorizations, and directives
  • Interfaces required to exchange health information with other providers, laboratories, pharmacies, patients, and government disease registries
  • Training type and scope (What levels of training will be needed? How many people need to be trained by the vendor?)
  • Availability of assistance (How much will be needed for how long)

Learn more from the How to Plan Your Project section.

Check out the Common EHR Functions section to learn more about options you may need.

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Decide How to Obtain Your EHR  

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.

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Check Out Possible Vendors   

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:

  • How long did it take to get up and running?
  • How much disruption and delay did you experience?
  • What worked to minimize loss in productivity?
  • Did the vendor charge additional or unexpected costs not in the original contract?
  • Have you performed an evaluation of the system? Is it helping you reach your goals?
  • What feedback can clinicians and staff currently using the EHR system provide?

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:

  • What kind of organization are you (e.g., for-profit, non-profit)?
  • How long have you been providing EHRs?
  • What local safety net providers do you work with? When did you start working with them?
  • What implementation and training services do you offer?
  • What is your price range for a system that fits basic needs of safety net providers?  
  • Do your prices include the cost of upgrades?
  • What type of support do you provide after launch?
  • Will you demonstrate your product?  Will you demonstrate a product in use at a provider’s site?

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:

  • Availability of Common EHR Functions 
  • Ability to integrate with other providers and data systems (e.g., practice management software, billing systems, and public health interfaces)
  • Capabilities to Ensure Privacy and Security  
  • Ability to link payments and EHR incentive rewards to implementation milestones and performance goals and conduct data queries for support of quality improvement.
  • Vendor service offerings
  • Implementation support (amount of support provided, type and scope of training, other services)
  • Server options (e.g., your server, or a web-based server, ASP)
  • Queries and reports for use in quality improvement

Read more about special safety net provider requirements in a Toolkit for EHR Selection to determine whether a vendor can meet these unique needs.

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:

  • Data migration
  • Hardware
  • Software
  • Maintenance
  • Upgrades
  • Connections needed for health information exchange
  • Customized reports
  • Option of phased payments

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Obtain Vendor Proposals

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):

  • Write a clear list of specific EHR system requirements
  • Prepare the criteria you will use to make a selection
  • Distribute copies of RFPs to selected vendors

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.

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Select Vendor

The vendor that offers the best fit with your selection criteria may not necessarily submit the best written or most attractive proposal. The most important thing is how each vendor’s proposal rates on the selection criteria that you included in the RFP.

Below are recommended steps for selecting the best proposal:

  • Ask several reviewers from your team to score proposals independently according to the evaluation criteria listed in your RFP
  • Compare reviewer comments and scores to determine the best value. Think about the best value as a combination of the proposed services, reputation of the vendor, customer service quality, as well as cost realism and competitiveness.
  • For the top scoring proposals, request and check references from current users.

Use contracting tools to help you make the best choice for your needs and budget. These tools include:

  • Reference Checking For EHR Vendors Worksheet
  • Vendor Evaluation Matrix Tool
  • Vendor Meaningful Use Compare Tool
  • Reference Checking For EHR Vendors Worksheet
  • Vendor Pricing Template

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Negotiate Contract

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.  

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Start Planning the Implementation

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.

Read more about this topic in the How to Implement Your EHR System.

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Work with Vendor After System Launch

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.  

View additional information about disaster recovery planning. 

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.

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