Making the Leap to a New EHR


What to know and when to act.

The drive for nationwide implementation of electronic health records (EHRs) began in earnest in 2009. That year, Congress committed to the support of universal EHR adoption and authorized incentive payments under Meaningful Use guidelines established by the Health Information Technology for Economic and Clinical Health (HITECH) Act. Meaningful Use criteria created the playbook that vendors and purchasers had to abide by in order to qualify for federal dollars. Now, six years later, the federal government has spent upwards of $30 billion both to spur the creation of a health information technology infrastructure and to encourage EHR acceptance through bonus payments to hospitals and physician practices. The incentive period, however, is coming to an end. Incentive payments are now being replaced with financial penalties ⎯ a looming 2016 reality for Medicare and Medicaid providers who have not yet made the transition to EHRs.

It is in this environment of financial incentives and penalties that usage has leap frogged to an adoption rate of more than 70 percent in physician practices.1 In fact, the majority of those who implemented an electronic health record solution between 2010 and 2013 noted that financial incentives or penalties played a major role in their decision.2 There is a flipside, however, to incentive-driven adoption ⎯ one that's creating a critical junction for many specialty providers.

Is it time to shift to a specialty solution?
The reality that many practitioners are facing today is that their EHR selection process may have been guided more by the necessity of meeting incentive deadlines than by an in-depth analysis of either the vendor supplying the solution or the exact benefits of the solution itself. The promise of a robust electronic health records solution may have dwindled in actual practice through the discovery that vendors who offer generic EHR solutions often don't have the capabilities or resources necessary for customization or innovation. Many specialty providers that chose an out-of-the-box generic solution have realized that it does not meet the needs of their unique specialty environment, particularly if that specialty is oncology.

Other providers are realizing that they may have chosen a vendor that does not comply with Meaningful Use guidelines and certifications mandated by the government, and that they may now be facing remediation deadlines and impending penalties for non-compliance.

These reasons alone are prompting many oncologists and other specialty practices to consider a shift to more fully featured solutions that complement, rather than complicate, the way they work. While the decision is a difficult one, it can be facilitated through the correct set of considerations.

How to ensure a best-fit EHR.
When contemplating a shift to a specialty EHR, there are multiple factors that should guide the decision-making process, particularly if the goal is to select a solution that can adapt to the changing needs of a specialty practice. These considerations include:

1. Vendor selection.
With hundreds of vendors to select from, how is it possible to narrow the field? Practices should start by looking at specialty-specific vendors and then dig into their expertise:

  • What is the vendor's footprint and reputation in the EHR industry?
  • What specialties are they in?
  • What is their level of knowledge and expertise in a given specialty?
  • How well do they understand the needs and time constraints of the community
    oncologist? Can they offer a solution that can give providers more time with their patients?
  • How committed is the vendor to specialty practices in terms of resources, strategy and mission?
  • What is their commitment to innovation and development? And more importantly, what are the proof points that showcase their innovation agenda?

In addition, when making the shift to a new specialty EHR solution, providers should ensure they're selecting a long-term partner ⎯ not just a vendor. Developing a partnership with a future-focused EHR provider can ensure that the growth and scale requirements of the business are managed in concert with its technology needs, so innovation and high functionality become embedded in the DNA of the practice. Simply put, a vendor's commitment shouldn't stop at broad-based healthcare IT. It should extend to supporting specialty physicians in every facet of the practice.

2. System functionality.
In a recent national survey of nearly 1,000 physicians conducted by Medical Economics, 67 percent of respondents were dissatisfied with the functionality of their EHR systems and indicated it was the number one factor that would influence a decision to change systems. The next closest influencer was cost.3 When shifting to a new EHR system, it is important for the practice to ensure functionality can be adapted to practice- and specialty-specific needs, and that regular updates over time will keep it current and viable in terms of both regulatory and practice changes. A technology solution is not a static system. In order to match the functional requirements of any given specialty, it must be able to change as the requirements change to match the daily life of the practice.

3. Data integrity during conversion.
A key consideration during any system shift is safeguarding and maintaining the integrity of the data during a new system configuration. This is why carefully vetting the expertise and depth of experience of a vendor during the selection process can be so critical in guaranteeing the success of a move to a new EHR system. Patient data, after all, is what powers a system's success. Savvy practices will put a premium on protecting it.

4. Training and education.
Getting the full benefit of a specialty EHR solution takes a level of commitment that does not end after the new system is installed. Training is the key to successful implementation and maintaining functionality over time. After initial training, refreshment training should occur every six months like clockwork, even more frequently as new features are introduced so both clinical and operational teams remain fluent in the specific attributes of the system. Additional and important training and support considerations also include an EHR partner's understanding of the day-to-day workflow of the practice and a professional services team that works in specialty practices every day and knows how different the workflow is from that of a general practitioner. A specialized solution doesn't end with data ⎯ it should encompass implementation professionals as well as support staff.

5. Data-sharing capabilities.
It's the new frontier. The ability to communicate with other specialists in the continuum of care is becoming more important every day, particularly in complex disease states. Maintaining a state-of-the-art EHR system helps practices stay abreast of their peers and can help guarantee that referrals are not lost because of inadequate data-sharing capabilities. 

Why is it worth the while to switch?
Transitioning to new technology is never easy. But practices that know the value of innovation in the therapeutic world also recognize that innovation, customization and forward-focused features in the technology world can make all the difference when it comes to thriving rather than just surviving. In the new age of healthcare, adopting is simply adapting. But the right EHR solution will do more than mitigate risk ⎯ it will sustain the practice well into the future.

Learn more about EHR Conversion Considerations.  


1 Office of the National Coordinator for Health Information Technology, ONC Data Brief No. 21/Physician Motivations for Adoption of Electronic Health Records. Pub. December 2014.
2 Ibid.
3 Medical Economics EHR survey probes physician about adoption, use of technology. (Slideshow). February 10, 2014.

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