Vendor Selection Criteria

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Choosing an electronic medical record (EMR) vendor is an important task, with many aspects to consider. An EMR can completely redesign a hospital's practice, but can also optimize it in ways a paper-based system could not. With over 400 EMR vendors in the market, selecting the best option could be overwhelming. After clearly defining the needs of the company, the next step is to evaluate which vendors more closely match your list of priorities.[1]

Here is a list of some of the important considerations when choosing, installing, implementing and upgrading an EMR system. [2]

EHR Vendor Selection

Preliminary selection criteria for EHR vendors

According to McDowell, et.al (2003), the primary and vital step for choosing vendors is to narrow your selection from over 400 to as few as 4 vendors based on the following key requirements. [3]

  • Is the EHR up-to-date with technology?
  • Are the core clinical components fully integrated in the EHR?
  • Are the applications available for inpatient, ambulatory, and outreach settings?
  • Does the vendor has a proven record of financial stability and management reliability?
  • Does the vendor have a well-established familiarity with large healthcare providers like academic medical centers and tertiary care hospitals?

Assess EHR Requirements

Before diving into specific attributes needed for an EHR system, the general requirements of the EHR must be decided. General requirement decisions may be needed for the following:[4]

  • Will the EHR be open source or off-the shelf commercial software?
  • What EHR functions are needed, such as patient demographic and care management data on patient visits?
  • What kind of clinical decision support and reports are critical, important, and desired but not essential?
  • What type of consents, authorizations, and directives are needed?
  • What interfaces are required to exchange health information with other providers, laboratories, pharmacies, patients, and government disease registries?
  • What type and scope of training is expected?
    • What levels of training will be needed?
    • How many people need to be trained by the vendor?
  • What availability for assistance will be necessary?
    • How much will be needed for how long?

Vendor Assessment

  • Collect information on several vendors and do gap analysis and start narrowing the field.

Steps to conducting an EHR Assessment

  • What is your facilities need for an EHR?
  • What are your goals for the EHR?
  • What could be the deal breakers
  • Start narrowing the field on the EHR selection [5]

Planning and Implementation Approach

Vendor Selection Criteria: Planning and Implementation Approach

Core clinical features

Vendor Selection Criteria: Core clinical features

Core clinical functionalities include a not only medication lists, allergy lists, order sets, and lab ordering, but also can include a fully integrated pharmacy/medication management interface.

IT and technical requirements

Vendor Selection Criteria: IT and technical requirements

Usability

Vendor Selection Criteria: Usability

Previous studies demonstrated how usability measurements can be applied to the evaluation of EHR systems; however, most of these studies were conducted post implementation. If significant problems have been discovered with usability, at this point in the system development life cycle it is usually too late to make any major modifications to the EHR system. Therefore, it is important to consider the usability criteria in early stages of the EHR implementation, and particularly during the process of vendor and product selection. [6]

Interoperability

Vendor Selection Criteria: Interoperability


Future relationship with vendor

Vendor Selection Criteria: Future relationship with vendor

Purchasing an EMR is a long-term decision with many hidden costs to consider.

Certification and meaningful use

Vendor Selection Criteria: Certification and meaningful use

Selecting an EMR is like buying a house where it needs thorough inspection/evaluation and making sure that every component is functional and meeting all the related requirements prior to approval and signing of contract. One must be able to confirm whether an EHR system is HIE certified or not.[7] In addition, meaningful use should be assessed.[8]

Vendor assessment

Vendor Selection Criteria: Vendor assessment

Most vendors typically fall into one of the three categories:

  1. Vendors that develop their own software organically on a single source code, one database, single instance.
  2. Vendors that may operate under one name, but offer several acquired products, including some custom programs.
  3. Vendors that have been acquired/sold/merged as a means to stay more competitive.

The first category of vendor is less likely to run into major market conflicts to keep its software modern and compliant with regulations. Vendors that operate on a single source code have far less difficultly staying current and/or responding to rapid changes in the market and mandated IT standards.[9] However, selection of a vendor also depends on the size of the organization, and the list of services they need. A larger health care organization might need more services, hence the vendor they select must offer multiple products.

Go live support

Vendor Selection Criteria: Go live support

Evaluation post implementation

Vendor Selection Criteria: Evaluation post implementation

References

  1. Selecting the right EMR vendor. http://www.himss.org/files/HIMSSorg/content/files/selectingemr_flyer2.pdf
  2. What factors should I consider when selecting a vendor? http://www.healthit.gov/providers-professionals/faqs/what-factors-should-i-consider-when-selecting-vendor
  3. McDowell, et.al. (2003). Journal of Healthcare Information Management. Herding Cats: The Challenges of EMR Vendor Selection. http://www.providersedge.com/ehdocs/ehr_articles/Herding_Cats-Challenges_of_EMR_Vendor_Selection.pdf.
  4. How to Select a Certified EHR. http://www.hrsa.gov/healthit/toolbox/healthitimplementation/implementationtopics/selectcertifiedehr/selectacertifiedehr_7.html
  5. http://www.healthit.gov/providers-professionals/faqs/how-do-i-select-vendor
  6. I. Saiku. Including usability in the procurement process of healthcare IT Systems. <http://www.soberit.hut.fi/T-121/shared/thesis/di-Inkeri-Saiku.pdf
  7. EHR/HIE: Interoperability http://interopwg.org/certification.html/
  8. Meaningful Use Definition and Objectives http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives
  9. Types of vendors http://www.greenwayhealth.com/wp-content/uploads/2013/03/Replacing_an_EHR-Coker_Greenway_white_paper.pdf