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Top 10 Things to Do for Considering a New EMR or Business Platform

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Independent Sales Partner, ISP, US Healthcare

EqualizeRCM Services‘ Partner, Corinne S. Smith, Clark Hill Strasburger, offers top ten list of things to do for companies considering a new EMR or business platform.


1. Do Your Homework
Too many companies do not perform enough due diligence to determine the right system for their healthcare entity. There are no “one size” fits all solutions that work across the board. Based on the size and sophistication of a healthcare entity, certain systems can be a much better fit. Check out KLAS rankings which are based on criteria such as physician group size or hospital bed size.

2. Decide whether You want a Cloud-based or Server-based Platform
Cloud-based services are frequently referred to as “software as a service” (“SAAS”) versus a solution based on a local or network server. Depending on your organizational resources, SAAS might be the only way to go. On the other hand, if you have a sophisticated IT system and staff, you might want a server based solution where you can ensure minimal downtime and possibly increased security. If you don’t have a strong IT infrastructure, you might want a cloud-based platform if the vendor will assume liability for cybersecurity and HIPAA breaches.

3. Check References
It is a universal fact that no one loves their EMR or practice management software. But, by checking KLAS ratings and soliciting unbiased software reviews from current users, you can minimize the risk of choosing the wrong system. Be wary of vendors who want to take you on “show and tell trips.” You can be guaranteed that you will only meet their happiest clients. It is much better to fund your own travel and get an unbiased opinion. Use your networking with MGMA, ACHE, or other professional associations to get recommendations. Find out how the vendor performed during the planning, go-live and post go-live support phases. Would the client buy the software again?

4. Know Your End User Requirements
What requirements will be deal breakers from an end user perspective? Will the physician demand for IPhone or IPad interface be a hard requirement? Can charge entry be done remotely? Does that matter? Ideally the organization should create a request for proposal that clearly outlines desired versus optional features.

5. Service Level Agreements
Create a firm project timeline and penalties to the vendor if they fail to install the product successfully and on-time. Also develop an SLA regarding responsiveness during each phase of the project and for on-going support during the length of the contract.

6. Requests for Proposal
In addition to product features and SLA, you can also embed legal requirements into your RFP so that vendors need not respond if they cannot meet the cyber liability, indemnification, or certification requirements of your organization.

7. Data Conversion
If you are transitioning from a legacy system, you will need to know which data elements will be converted and which will be maintained in the legacy system as well as how the data will be accessed from the new system. Healthcare organizations have a legal duty to be able to produce or access prior systems for reimbursement, patient care or litigation. Usually, the new vendor is not assuming that obligation without compensation.

8. Look for Hidden Costs
Providers should look for hidden costs, like additional charges for interface, training and the like. Many vendors use vague language such that these services end up being additional add-on costs.

9. Hold-back Provision
The biggest mistake an organization can make is paying too much money up front before a product is fully tested and put into production. Hold money in reserve for after testing and go-live so you have leverage. It is the same principle homeowners should use when using a contractor. If the vendor is paid in full upfront, there’s just not the same level of urgency to fix that punch-list of outstanding items.

10. EHR Certification
Providers should refer to the Office of the National Coordinator (ONC) for Health IT’s website that lists vendor requirements, regulations and certifications. Medicare reimbursement continues to tie-back to the EHR vendor’s capability to provide an ONC-certified product. Do not rely on the verbal representation from the sales rep. Check the ONC site for current version certification information.

In closing, be careful of any vendor that is unwilling to carefully document the project timeline and go-live details. Boilerplate templates are standard, but most vendors are willing to make some concessions or addendums for regulatory or insurance requirements. Even if you are not able to negotiate all of these points, at least you will go into the contract with greater awareness of the contracting pitfalls. Finally, never enter into any agreements related to IT systems without a solid business associate agreement.

Corinne S. Smith is a healthcare lawyer with Clark Hill Strasburger. The firm is a full-service law firm with 650 lawyers in 11 states. A large healthcare practice group focuses on corporate transactions, regulatory issues and healthcare operations. Corinne has a unique practice as she is also a Fellow in the American College of Healthcare Executives with distinct business experience in healthcare operations, revenue cycle, strategy and business development. She is a graduate of St. Mary’s School of Law in San Antonio and also has a Master of Science in Healthcare Administration from Trinity University. Prior to joining Clark Hill Strasburger, Corinne served as in-house counsel for Seton Healthcare Family and the UT Health San Antonio (f/k/a UT Medicine San Antonio). One of Corinne’s specialty areas is working with physician practice groups and hospitals to negotiate IT contracts for electronic medical records (EMR) and billing systems. She has assisted practice and hospital leaders in creating request for proposal (RFP) criteria, evaluating proposals and negotiating favorable contract terms with healthcare giants like Cerner, Epic, Athena and MediTech.        

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