The Complete Guide To Selecting An EHR Vendor

How To Select An EHR Vendor

The EHR vendor selection process is no small task.

An EHR system is a significant expense and most EHR vendors have a long onboarding and data migration process that could interrupt your day-to-day workflow. And that’s to say nothing of the fact that your business and patients are depending on a reliable, user-friendly system with accurate data.

These are 7 important steps when choosing an EHR vendor. We’ll examine these in more detail later this article.

  1. Decide If It’s Really Time To Select A New EHR System

    Migrating electronic health records is labor and time-intensive. Make sure that you are fully prepared to take on the challenge and to spend the time on this endeavor. Also be sure the vendors you’re evaluating have a well-defined onboarding process with a well-equipped support team.

    Should You Select A New EHR Vendor?

  2. Determine Why You Want To Change EHR Vendors

    Do you need to change EHR vendors or do you want to? You might need to change EHR systems because yours is sunsetting, or your business merged. You might want to change EHRs because you want enhanced functionalities like integrated telehealth, or an improved UI. Understanding your situation will help you make a better, more informed decision.

    Why Switch EHR Vendors?

  3. Decide What Type Of EHR System Is Best For Your Needs

    Right now, the most common types of EHR systems are cloud-based, web-based, SaaS-based and self-hosted. We’ll explain the different types later, but make sure you understand the benefits and drawbacks of each type before making a decision.

    Different Types of EHR Software Systems

  4. Determine Your Budget and Total Cost

    EHR vendor contracts are generally multi-year agreements and the upfront costs associated with choosing a different vendor might seem like a setback at first. But selecting an EHR system with time savings, reduced days in A/R, and improved patient loyalty, can pay major dividends down the line. Make sure you can make the upfront investment and see a return on it in a timeframe that makes sense for you.

    Things To Consider When Selecting An EHR Vendor

  5. Decide What EHR Features Are Most Important To You

    Not all features are important and some may be more important to others than to you. Take a moment to define your business goals and your patient needs from an EHR to identify the EHR features that matter most to you.

    Which EHR Features Are Most Important?

  6. Compile A List Of EHR Vendors To Compare

    Now that you know your budget, your potential ROI, the type of EHR systems that fits best for your needs and decided on the most important features to you, it’s time to start choosing EHR vendors to compare. Make a checklist of criteria and research online and speak to sales reps and check the boxes on your list so you can evaluate them in an organized way. Schedule demos and take your time during this process, it’s an important step!

    How To Compare EHR Vendors

  7. Make Sure Fit, Features, EHR Implementation Cost & Support Align

    Now that you’ve narrowed your search down, do a final evaluation of your options. Read reviews, ask for referrals from the sales people and do your due diligence so you can make your decision on your new EHR vendor with confidence.

    See If Azalea Is A Good Fit For You

With those 7 steps in mind, we created this guide to selecting an EHR vendor that goes into all of these in greater detail. Use the links below to navigate or read at your own pace!

Is It Time to Select A New EHR Vendor?

Medical teams love to hate their EHRs – and often with good reason.

EHRs are frequently cited as a key reason for physician burnout and job dissatisfaction. A 2016 survey of 6,375 U.S. doctors reported that 84.5% of them used EHRs. According to the study, published in Mayo Clinic Proceedings, physicians using EHRs felt less satisfied with the amount of time spent on clerical tasks and were at a higher risk of professional burnout.

Those findings are confirmed in the 2017 Medscape Physician Compensation Report, which surveyed 19,200 physicians in more than 27 specialties. The time spent on bureaucratic tasks continues to rise, and in turn, physician dissatisfaction.

In the 2014 report, 35% of employed and 26% of self-employed physicians spent at least 10 hours per week on paperwork. For 2017, the percentage rose to 57% of all physicians.

Research by the Annals of Internal Medicine put the amount of time spent on data input even higher. This report states that physicians now spend nearly 50% of their time on their EHR doing desk work, and only 27% of their time interacting with patients.

The 3,200 respondents to Medical Economics’ 2017 EHR Report Card identified three main disadvantages of their EHR system when it came to daily operations:

  • 76% – spending too much time entering data not directly related to patient care/outcomes
  • 57% – disrupting practice workflow
  • 56% – not allowing eye contact with patients during examinations

7 Common Reasons Why Practices Switch EHR Vendors

Practices thinking about making a switch may face situations where they have no choice. These could include:

  1. Your existing EHR vendor will no longer support or enhance the current system
  2. A merger has resulted in multiple EHRs with potential interoperability
  3. Your EHR isn’t certified for federally mandated program like Meaningful Use and MACRA

However, most practices and health systems have time to consider options and make an informed decision. Common reasons to switch EHR vendors might include:

  1. Enhanced functionality – adding integrated telehealth capabilities or a combined back office/front office platform with revenue cycle management capabilities.
  2. User friendly interface – if your existing EHR is non-intuitive, it might be time to make a change; a 2015 report from HealthcareITNews cites “cumbersome” and “faulty” EHR interfaces as the driving factor behind 24% of EHR changes.
  3. Poor performance – such time-gobblers as difficulty in entering data, frequent crashes, delayed data access and more.
  4. Lack of interoperability – a constant challenge for health care, the inability of an EHR to exchange data with other systems can be a deciding factor.

What Are The Different Types of EHR Systems?

There are 3 different types of EHR software system: web-based EHRs, cloud-based EHRs and SaaS (software as a service.) What is the best type of EHR or healthcare software? We will examine the pros and cons of each different type.

Web-Based EHR

Web-based means that the software’s user interface is accessed through an internet browser, i.e. Chrome, Safari, Internet Explorer. It’s powerful to open a browser on any trusted computer, log in and access your EHR. It really does mean anytime, anywhere – as long as you have internet.

Outdated EHRs and legacy software companies often deter customers from web-based software under the claim that it is unreliable.

This is simply not true.

Most IT professionals will recommend a small investment in a backup internet connection as an insurance policy. If needed, a backup connection for peace-of-mind and efficiency is worth every penny.

Web-based software is the preferred choice and the direction most every software industry is moving.

Cloud-based EHR

Where and what is “the cloud?”

When we first heard about “the cloud” people were skeptical and insecure about where your data storage and security. In the most basic of terms, “the cloud” is a network of servers (the internet) that delivers software and data to your computer.

Being cloud-based means that you can access your data, photos, music or software from anywhere at any time. Usually this means a single server is not solely responsible for your data, which is good. With the rise of hacking we have seen a rise in the encryption of data to protect it.

The main benefits of using cloud-based software are cost, scalability and quick access. The cloud is here to stay and is widely accepted as safe and reliable.

The counterpart to cloud-based systems are “on premise” systems.  

In the consumer software industry, on premise software solutions are typically legacy or older technology. Many legacy software systems require IT professionals to maintain server hardware and software, security updates, data vulnerability detection, and backups. 

Maintaining servers locally is expensive and risky. You also hear these systems referred to as “client-server” software.

Modern software companies, like Azalea Health, understand the burden “on premise” systems put on practices and hospitals. Cloud-based EHR allow practices to focus on delivering healthcare without  having to worry about patients’ data or security updates on servers. Doctors get to focus on patients, and software companies take care of the software and hardware.


SaaS typically refers to the pricing model associated with cloud-based software. Rather than buy a license from Microsoft for their latest edition of Office, you pay a subscription fee and you always have access to their most recent software.

When you look at SaaS through the Health IT lens, it means lower upfront costs and eliminates the need for hardware and software updates. When software companies control version roll out, they can provide a better user experience by releasing features over time as well as access to implement corrections and security updates minimizing downtime.

The forecast for Health IT is web-based, cloud-based, and SaaS software solutions. If your Health IT provider is not taking steps to keep your software up to date with modern technology, talk to one of our sales consultants to discuss how Azalea Health could benefit your medical practice or hospital.

What Should You Consider When Selecting An EHR System?

For most people today, dating offers a way to decide what you can – and can’t – live with in a spouse or significant other. Unfortunately, there isn’t a dating period with EHRs. Instead, you look at the EHR’s features touted by developers and consultants and make an expensive, long-term decision.

According to Medical Economics’ 2017 EHR Report Card, almost two-thirds of the 3,200 respondents  switched EHRs during their career. While nearly half of the 62% who switched attribute it to a change in employment status or practice location, the rest changed EHR vendors due to difficulties and deficiencies. The replacement trend continues in 2019 with Reaction Data reporting 27% of office-based physicians plan to replace their EHR by the fall of 2020.

Is Your EHR Vendor A Good Match For You?

Does your EHR vendor understand your practice and business model? This is one of the first questions you should answer during the EMR software selection process. If you’re a PCP serving a rural market, you don’t need – and probably can’t afford – something like Epic or Cerner which are designed for major health systems. You should also avoid highly specialized software (for example, plastic surgery) that isn’t designed for your clinical and billing needs.

Medical Economics also asked what capabilities practices are want in a new EHR system. The replies are diverse and provide a helpful checklist in seeking out a new EHR system.

  • 58% – improved ability to customize
  • 46% – improved quality metrics measuring
  • 43% – better vendor support
  • 39% – cost efficiency
  • 34% – better billing capability
  • 33% – better population health capability
  • 31% – other

What Are Most Important EMR Evaluation Criteria?

While everyone has unique EMR selection criteria to assess, we think these 6 factors should rank highest when evaluating EMR products.

  1. Implementation

    Ask about the quality and amount of training, and whether the training will be conducted onsite or via online courses. Each have advantages and you’ll need to decide which works best for your environment.

  2. Customization

    This is a major pain point for many practices, especially specialties. If you are part of a multi-specialty practices or health system, your EHR will probably be more general. Even so, it is still helpful to have specialty modules available. Also, the ability to internally modify or configure certain features within the EHR may be attractive.

  3. Customer service

    As you review the vendor’s capabilities, ask about key customer support issues and functions. What is the average wait time on a support call? How is their ability to resolve technical problems? What is their quality of communication on resolving issues? What is the response time when resolving an issue?

  4. Productivity

    If you’re buying a car, you test drive it first. Make sure to follow up on the sales rep’s well-practiced navigation of the system by trying certain functions for yourself, such as moving within different sections of the EHR, navigating through a patient visit, and accessing specific, important data.

  5. Technology

    Where will your data reside? Some EHRs are now using the cloud to provide anywhere access to data while maintaining high, HIPAA-compliant security. 

  6. Financial impact

    This goes beyond just the cost of purchase and implementation. Will the new system support e-prescribing and telehealth? How difficult is it to exchange patient health information with specialists and other providers?

Which EHR Features Matter The Most?

When comparing EHR vendors, you’ll likely be overwhelmed with features and technical terms. Fortunately, not all of those features matter. We regularly listen to overburdened healthcare workers about their pet peeves and stresses. As a result, we engineered our software specifically to save you time and reduce stress. If you can save one minute per patient in a practice where the physician sees an average of 20 patients a day, you’ll end up with a time savings of 6.6 hours a month! Here’s our list of 3 important EHR features that we think really do matter and help save you time.

1. Customizable scheduler

Unfortunately, a calendar can’t add more hours into your day or make the work week shorter. The good news is, the customizable nature of Azalea’s scheduler can make scheduling throughout the week easier. Here’s how:
  • Does your office close for an hour for lunch every day? You can easily block out that time within the scheduler.
  • Do certain types of appointments require different time allotments? Set new patient appointments for one length and check-ups for another. The correct amount of time is blocked automatically when you schedule that type of appointment.
  • Easily customize the scheduler for your practice’s needs and reduce repetitive tasks. It can even make training new hires easier.
  • Automated eligibility checks are visible on the scheduler for quick viewing. No need to log into insurance portals.
  • Each user can choose how they want to view the scheduler!  You can choose to view the scheduler as a week overview, day view, agenda view, or openings only.

2. Easy navigation

Today’s young people may never know the frustration of wrestling with an oversized paper map. However, navigating a piece of software can be as annoying as a paper map, especially if you have to click through page after page to get to a particular screen. That’s why Azalea streamlined its navigation and made sure that it was intuitive for a range of users. The top navigation bar guides you naturally through scheduling steps, seeing a patient and billing for their visit. While in a patient chart, you can use the left navigation to see demographics, documents, medical history, and patient specific billing information.
“I Go For Less Clicks and Easy To Use.”

3. Shared charting

Before EHRs there were paper records, which usually consisted of an entire file of sheets of paper. If it was in the exam room, the office staff wasn’t able to add documents or notes until after the patient visit, and it might visit several desks before being refiled. Today the majority of practices in the U.S. have an EHR. However, there still can be a wait to enter data if someone else is editing or adding to the patient file. Azalea EHR’s Collaborative Charting™ ends that linear entry process by letting multiple team members work on the same chart at the same time.

What Does This Mean For You?

It might not seem like much at first glance, but with a partner like Azalea, you realize what a difference the little things can make in your day-to-day workflow. Finding the time needed to run a practice or hospital smoothly can be challenging, but customizable schedulers, easy navigation and shared charting can give you back some of the valuable time you need.

Additional Resources


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