Buying an electronic health record system can be a challenge given the number of vendors and the range of features that the products have to offer. On the surface, most EHR tools seem to offer the same broad set of features and capabilities across the spectrum, but there are still key differences among these products, making some better suited for some organizations than others depending on the size of the target healthcare organization. For example, hospitals generally require more modules from the EHR platform that can support radiology, labs and ER and while only practice management modules are necessary for outpatient settings. To successfully compare EHR systems, buyers must perform in-depth features analysis to determine the most practical, effective (and affordable) system.
Most physicians prefer EHR software that allows them to customize some of the clinical forms that they use during the care episode. With this flexibility, the health organization can experience less friction as the clinical team interacts with the EHR system and collects the most relevant information for themselves and their patients. Applications like GE Centricity offer tools like Visual Designer that allows IT, physicians and consultants to build and enhance clinical forms. Other platforms offer similar capabilities to customize the screens and forms that the clinical staff members interact with. AthenaHealth and Centricity perform customization directly through the web browser, meaning that no additional software is required.
When buyers compare EHR systems, they must know what certification they require. If the buyer is looking to participate in any of the federal healthcare initiatives like MACRA, MIPS and other CMS-based programs, they will need to determine if prospective software meets the certification criteria set by the ONC for Health Information Technology. Greenway Health, AthenaHealth, Allscripts, eClinicalWorks, NextGen and GE Centricity are among the vendors that meet the current certification requirements. According to the Centers for Medicare and Medicaid Services, vendors receive Certified EHR Technology once they meet the requirements but should note that they may have to get recertified if the requirements change over time.
UX and end-user experience
Suitable EHR tools should be easy to use and accessible for users. Physicians, nurses and other clinical support staff spend a significant amount of time in the EHR where they capture and review patient information. If the user interface requires them to switch between too many screens and windows, users can become frustrated. End users are finding that products that utilize new modern controls and take advantage of web-based functionality offer a much better experience and are more efficient. Users give particularly notable reviews for AthenaHealth, Greenway Health, eClinicalWorks and NextGen for their user experience.
Support of mobile apps
Doctors often review clinical data while they are on the go, so it has become imperative for buyers to ensure that vendors offer mobile access to medical records when they compare EHR systems. Buyers should note that some vendors do not offer full EHR desktop functionality in their mobile apps, but this is mainly due to limitations that include lack of support for third-party hardware (scanners, medical devices, etc.) and limitations of the operating system such as lack of support for multiple tabs or screens. For some more well-established EHR products, many of them have added the mobile functionality as an add-on to compete in the market, but for others vendors that were born in the cloud like AthenaHealth, DrChrono or Practice Fusion, the mobile experience was always part of their products, and in most cases, released along with the full desktop or browser.
Despite the shift from paper-based charts to digital health records, many medical organizations still use paper documents. Patients even still file their medical and social history on paper documents and bring their paper medical records with them to the practice so buyers must ensure that the selected software is able to scan and manage these records efficiently when they compare EHR systems. GE Centricity is particularly strong in its document management capabilities with the most comprehensive document scanning and indexing features. For primary care physicians, the volume of paper-based documents may be higher than in an orthopedics or other acute settings, so EHR tools with strong document management capabilities would be most valuable in these settings.
In recent years, there has been a big push by payers, federal and state entities for physicians to shift from fee-based services to an outcome-based care payment model in order to address the rising costs of healthcare and help improve the population health. A successful population health initiative requires the software application to aggregate and analyze the patient health data that the EHR platform stores. As a result, many EHR vendors have been introducing new modules within their systems to help clinical professionals' access the population analysis directly from within the EHR and then connect some of the data elements that they are already tracking within their system. When buyers compare EHR systems, they should know that, for years, NextGen, AthenaHealth, Allscripts, Epic and Cerner have been making the push to include and enhance population health capabilities within their EHR system such as population health management dashboards, quality care reporting and patient portals to help with patient engagement.
Workflow engine and automation
Automation has become an important feature to make healthcare organizations more efficient and proactive in patient care. Some EHR products offer automation and workflow engines that can help automatically alert the clinical team to prospective issues like when a patient misses a follow-up visit or abnormal lab results that providers should review and discuss. Automation features may include capabilities like routing encounters to coders when the CPT codes that physicians select may cause denials or underpayment. Having automation and a workflow engine that admins can customize to fit the needs of an organization can be very valuable when it helps automate task creation. AthenaHealth, NextGen and Greenway Health offer such features.
With extensive research into the EHR market, TechTarget editors have focused this series of articles on EHR software with considerable market presence that offer a cloud-based platform option. Our research included Gartner, Forrester and TechTarget surveys.
Hosted or cloud-based EHR
Many healthcare organizations are looking to reduce their infrastructure footprint and rely solely on off-site hosting services or the EHR vendor to manage and maintain the EHR software. Vendors that are pure cloud platforms or born in the cloud like DrChrono, AthenaHealth and Practice Fusion are running applications on their own data centers with no option for medical organizations to download or install it locally in their servers. Their licensing model is also a subscription only. Although their EHR software is based on a client-server model where the software is hosted on premises, Allscripts, NextGen and eClinicalWorks are also available under a subscription model where the vendor or a third party hosts the services.
Reporting and data analytics
In the past, most EHR software focused primarily on delivering accurate reports relating to basic things like number of patients with certain conditions, meaningful use reporting, scheduling trends, revenue cycle reports, patient reminders and billing reports around the services they provide. Today, more and more vendors recognize the importance of data analytics where the patient data that EHR tools store can provide more meaningful insights into patients. Healthcare providers need to identify high-risk patients and evaluate any opportunities for interventions and treatments and perform a thorough EHR systems comparison to vet this new data analytics features. There are even newer forms of analytics that focus on the prescriptive side. EHR software analyzes data in order to provide feedback around recommendations for treatment plans and patient actions and has the ability to predict the outcomes for each of these actions the software presents. Vendors like NextGen, AthenaHealth and Allscripts provide advanced analytics capabilities focused around delivering more insights into population health.
Given the short list of certified EHR platforms to pick from in the marketplace, it can be a daunting task to compare EHR systems. Each product and company behind the EHR platform highlights its own differentiator in the marketplace. Nevertheless, many find it hard to differentiate from all the products they consider since most are trying to meet the feature and functionality demands of the same target audiences. But as buyers look closely at each of the prospective platforms, subtle differences can make a significant difference.