March 09, 2021

Every healthcare provider I know complains about the hassles associated with their EHR charting. 

When you’re an employed physician, you basically get stuck using whatever software your employer has purchased, and it’s super easy to complain about something that you have no control over. 

But when you are the practice owner, you choose the EHR—an admittedly overwhelming process. And before we get started, let me explain the difference between EMR and EHR. EMR stands for electronic medical record. Restated, this is your note. EHR stands for Electronic health record. This includes all sorts of other documents including  lab and imaging results, notes from other providers and all sorts of miscellaneous documentation. 

Now that you know the differences between EMR and EHR, you will have to choose the right software product for your practice. Before you even start looking at individual products, there are a couple of key concepts that I want you to consider. 

1. Determine whether you want an EHR that’s enterprise or cloud based. 

• Enterprise-based EHRs live on your server or servers in your office
  • Do you have a server? 
  • How much does a server cost? 
  • What happens when the server goes down? 
  • Do you have in-house IT person for when your server isn’t working?
• Cloud based EHR sits in the cloud and can be accessed from any device.
  • You don’t need a server.
  • You need a stable internet connection
  • Bandwidth and internet speed affect performance

There are obvious differences in the costs between enterprise- and cloud-based products but the cost differences may not be as great as you would initially think.

Tip: Create a spreadsheet so that you can compare all of the costs. 

• What type of infrastructure do you need and what does that cost? (Servers vs. wiring for the fastest internet connection)
• Cost of the internet service with the bandwidth needed to run a cloud-based program.
• What is the purchase price? And what does that include?
• For the enterprise-based is there a yearly maintenance fee? 
• Costs associated with cloud based—how much do you pay per month? Is it by user? How often do they raise their prices? 

2. Determine whether you want a standalone EHR and standalone Practice Management Software or an integrated product. 

EHR and Practice Management Software are not the same thing.

• EHR—all of the clinical info
• Practice Management—the business side of medicine 
  • Eligibility, prior authorization, billing,  and patient statements
• Scheduling can be part of EHR and/or Practice Management Software
• And you need both in order for your practice to function. 

Deciding whether you want an enterprise based system or cloud based system and whether you want a standalone EHR with standalone Practice Management software vs. an integrated product will have the biggest impacts on your budget and workflow. These decisions will also guide your consideration of specific vendors and their products.

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