What health record solution is right for your practice?

I have a checklist, based on interviews conducted over the last year, of some things you need to ask about.
Written by Dana Blankenhorn, Inactive

While industry and the government continue their dance around the "meaningful use" rules -- it's too hard, too soft, insecure, etc.) thousands of clinics, hospitals and small medical practices still face the hard question.

You need something installed and proving its value by October 1 of next year or no 2011 stimulus check. You're being pressed for a decision by vendors, your accountant and the government.

What you should be looking for? (Picture from the fine design blog Designing for Humans.)

I don't have a pat answer for you. Instead, I have a checklist, based on interviews conducted over the last year, of some things you need to ask about.

1. CCRs in English -- A Continuity of Care Record (or Continuity of Care Document) is what you will be handing each patient when they leave you after all this is done. The document will mainly be prepared by your EHR software, based on inputs you give it while the patient is with you. It's not too much to ask that these documents be written in English, simple English a patient can understand, not medical gobbledygook.

2. Interoperability -- Your state, city, or region is going to build an exchange for health records. What standards will it be using, and will the data you generate from your EHR be compatible, so you can send records to a hospital or get records from a specialist? No waffling -- yes or no.

3. Security -- Not just passwords, or encryption, or even audit trails. You need to be able to perform a risk assessment on your system -- or have someone else do it -- at any time. You need procedures that your own people understand for this process.

4. On-site training -- Everyone on your staff needs to not only learn how to use this stuff (you included), but know they can get support, in English, whenever they need it. This is a question best answered by talking to other customers. Get references. Buy those references a drink, or three. Get the straight poop on this, because it's key.

5. Commitment -- Maybe this won't work. Any IT engagement starts as just that. It may become a marriage with time, maybe a dysfunctional one. But you need to know how you can get out of it before you go into it. Try before you buy works for me.

Note that in this list I didn't talk about speeds and feeds. I didn't talk about operating systems, or your client devices (ooh -- a tablet! An iPhone!). I didn't talk about open source vs. proprietary, or even whether you should be buying gear or using Software as a Service (SaaS).

You need to look at this decision strictly from your own point of view.

  • What's in it for me? How will this drive improvements to the way I practice?
  • What's in it for my patients? How will this help them understand what they need to do, and change habits?
  • What do I have to do, as opposed to what do I want to do? Do what you have to do for the 2011 stimulus, and the 2013-2015 wish lists will take care of themselves.

The meaningful use guidelines, on which public comment has now begun, are not telling you to buy hardware, software or services. They are telling you to get the data you need to improve your practice and your patients' outcomes.

Before you start fighting any alligators, make certain you keep that drained swamp at the top of your mind.

Good luck, and let me know how it goes.

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