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The proliferation of EMR vendors
By the AMA count, there are almost four hundred EMR vendors hustling for customers, which is why the range of quality, from wannabe software designers to experienced vendors selling systems of genuine quality at a fair price. Naturally, they all claim to offer the best product. They obviously don’t. Some are better than others.

Also you need to know if a prospective vendor is a reseller or a manufacturer. There are many vendors on the market selling the same system under different names. A vendor that makes its own EMR is more intimate with its code and would have a much more realistic understanding of possible enhancement requirements to the software.
Questions that need to be asked
You should look for a vendor who sought the advice and input of physicians and health care professionals. The best EMR vendors hire clinicians as advisors. This helps the vendor understand what physicians need and want, what works and what is just clutter.

You should research the history of the vendor. How long has it been around? Is the company stable? Is it profitable? How many clients does it have? Is it growing? Will it be around to support you in the long run? Does it have other clients in your specialty or in your area? Ask.

If a vendor has clients in your area, find out who they are. You might try contacting them to see what their experience has been.

Then there’s the critical question of research and development. Is a prospective vendor committed to developing better software? If you buy their system will it evolve to include new functions? How often does a vendor release updates and new versions of its software? Do you have to pay for these updates separately from your original contract?
Before you start shopping for an EMR system
You need to make sure that the vendor explains carefully how their EMR system is designed to work. If you have questions, ask them. If you don’t have a person on your staff who understands EMR technology, you have to be extra careful. Remember, if you have a small office or clinic, you won’t have the same resources as a hospital. A vendor’s personal service is important. Being a numbered account in a large organization doesn’t mean you’re getting the best service.
About the size of the EMR vendor
The quality of EMR software doesn’t depend on how large a vendor is, but how honest and dedicated they are and how skilled their technicians are.
Before you sign a contract
Make sure a prospective vendor gives you a specific delivery date for the software. You should know when the EMR system will be installed and when the training will take place. You should have a date when the system will be up and running. You need a plan, with responsibilities of both yourself and vendor clearly defined. Penalties should be well defined for vendors who don’t meet their obligations. These are few things to take in consideration before signing a contract.
Things that should worry a prospective EMR buyert
You need to make sure that what you see in a demo is what you’re going to get. You need to make your expectations are clear, and your vendor should make sure he understands exactly what you want. Anything short of that will result in hard feelings by both you and vendor, and that is never good for an ongoing relationship.

Installing EMR in an office or clinic is a kind of partnership, a long-term, mutual journey of both you and the vendor, and it requires equal, good-faith commitment by both. For example, the vendor doesn’t know what your fee schedules are unless you tell him. You don’t know how to configure the schedules unless you get help.
The need to assess workflow
One thing usually accounting for discrepancies between the expectations of a provider and vendor is that there was no assessment of workflow before the vendor installed an EMR system. An assessment of workflow should be part of the contract. Who in your office does what? What happens when a patient arrives? How do you record and use your patient data?
What to consider if your office is growing
You should find out if a vendor is selling an EMR system as modules that can be expanded or if the system is a set package. You might want to start with a modular system, beginning with transcription and image documentation and save charting at point-of-care for later. A modular system is generally cheaper and will give your staff time to master the basics before you add more functions. Whatever you choose, a modular or a complete system, you should look for flexibility.
Why flexibility is important
EMR shouldn’t hinder your current workflow. Take documentation. Some systems require that you use a single template for the entire practice. You will want to be able to tailor the templates to fit your specialty without a lot of hassle. A good system will allow you to type in free text, dictate notes, or write them in by hand. Your choice.

Some vendors might tout the fact that a physician can tailor templates—oh yeah, sure, sure, no problem—but in practice it almost takes a rocket scientist to figure out how to do it. When a vendor says something is easy it should be just that, easy. Find out before you buy.
Sending EMR data
An EMR system should allow you to connect your practice to labs, pharmacies, health information portals, practices and clinics, homecare agencies, and hospitals.
The importance of installation and training
You will need it made clear whether you have to pay for travel expenses for trainers or if they even will come to your office or clinics. And do the installers and trainers work directly for the vendor or are they working on a subcontract? Generally speaking, you’ll get the most consistent, quality work if they work directly for the vendor.

Another related issue is one of time zones. Will support technicians be available when you need them? If your clinic is on Pacific Time and your vendor operates on Eastern Time, will your technical support shut down at 3 p.m.?
More tips before signing a contract
You should never sign a contract if all you have talked to is a salesman. Not all vendors and sales people are honest; they’re not all dishonest either. A salesperson always has his or her mind on the close, anything to get you to put your name on a contract. Your mind should be on getting the best deal on dependable EMR software that’s appropriate for your specialty and your office. You need to see somebody from the vendor other than a salesperson before you agree to an EMR contract.
When things don’t work out between a provider and a vendor
You and your vendor should agree upon time lines for training and installation, but you also need to keep up your end of the agreement. Many things can go wrong: equipment installed by third-party vendors malfunctioned; the vendor didn’t deliver what was promised; the tailored templates weren’t delivered on time; training was inadequate; the software didn’t meet the requirements of your requirements; the vendor has not been responsive.

Good vendors want happy customers, but training and implementation is expensive. If the time line just isn’t working and it’s costing you money, don’t hesitate to use the out clause and start considering other vendors. In short, you contracted for a good EMR system with support for installation and the rest of it. Make sure your vendor lives up to his end of the deal.