From acute care to long-term care, home care to hospice, electronic medical records (EMR) are no longer a choice, but a necessity. But for home health agencies (HHAs) and hospice providers looking for a quality EMR solution, the challenge can be daunting. The investment in a new EMR is huge, and with the ever-evolving regulatory requirements and literally hundreds of EMR systems and vendors to choose from, it might be hard to know how—and where—to start.
What exactly IS an EMR?
A good place to begin is understanding the name itself. An EMR is defined as a digital version of a patient’s chart within a single healthcare organization or medical practice. The EMR record includes the medical history and other patient information recorded by clinicians and staff within that organization. Usually incorporating point of care documentation using web-based or cloud-based software on a mobile device, EMRs allow authorized users to create, manage, and extract patient data as necessary.
In the world of health information technology (HIT) the term “EMR” is sometimes used interchangeably with “EHR” (electronic health record). There is a difference, however. EHR systems conform to nationally recognized interoperability standards and include patient records from across the healthcare continuum: physician’s offices and pharmacies, hospitals and laboratories, long term and post-acute care (LTPAC) settings.
What defines a quality EMR solution?
Interoperability is one of the most crucial features of an EMR system. HIMSS (Healthcare Information and Management Systems Society) defines interoperability as the ability of different HIT systems to connect within and across organizational boundaries in order to cooperatively exchange and utilize data. Interoperability relates to the transfer of information or data from one healthcare provider or organization to another. An EMR system with limited and/or ineffective interoperability is not an EMR solution, because it does not enable a patient’s electronic medical record to become part of their broader EHR.
This is where Thornberry Ltd and NDoc® stand out. Interoperability is especially important for hospice and HHAs because LTPAC patients are much more likely to have chronic conditions and comorbidities that necessitate frequent transition between multiple care providers. Most EMR systems tout their interoperability capabilities, but in reality, seamless interoperability among EMR vendor systems is rare. NDoc incorporates a standards-based approach to interoperability and information exchange and is fully CCHIT Certified® 2011. The NDoc EMR system has proven itself in the secure, seamless, and reliable transfer of clinical health data.
Interoperability is at the top of the list, but there are a lot of features and capabilities that are crucial in a quality EMR system and vendor. Look for:
- Interface Capabilities: Will the EMR integrate easily with other software solutions at your agency?
- Regulatory Compliance: Will it help your agency meet all current and upcoming regulatory requirements such as OASIS-D, PDGM (Patient-Driven Groupings Model), and EVV (Electronic Visit Verification)?
- Efficiency and Effectiveness: Can the system help streamline agency processes and procedures? Can it save time for clinicians and/or agency staff?
- Cost Controls: Does it offer, for example, automated mileage tracking for increased accuracy and proven cost savings?
- Customization: Can it be customized to your agency’s individual requirements?
- Report Capabilities: Does it allow the data to be easily accessed in reports for episodic, operational and business analysis?
- System Help: Does it offer embedded help text to aid clinicians in the field?
- Vendor Support: Does the EMR vendor offer ongoing service and support?
What do other providers have to say?
You shouldn’t rely solely on the word of an EMR vendor in your search for a quality EMR solution. Look to other hospice and HHA providers for what works, and what doesn’t. Thornberry has been ranked #1 in Home Health for the sixth year in a row by provider agencies and independent researchers.
Your state home health or hospice association may be able to provide information on what systems are being used in your area and direct you to colleagues who are willing to discuss their EMR software systems with you. But don’t just ask what system a colleague is using. Instead find out why they are using that system, what they like and don’t like about it. Ask:
- What do you like about your EMR, and what do the system users (clinicians) think about it?
- Is your EMR vendor responsive to your changing needs?
- Does your vendor offer ongoing system support and training?
- Has the system improved agency efficiency?
- Do you consider your EMR a quality solution?
- What needs are not being met by your EMR system?
- How and why did you select your EMR vendor?
- Did you consider any other vendors before you made your final decision?
Online Research: User Reviews
In addition to talking with other agency providers, you should head online to find out more about what others have to say. You’ll find that reviews differ from site to site.
KLAS Research offers anonymous user reviews/comments and ratings of software/vendors that are initiated by KLAS based on interest from the provider community. Vendors are evaluated by category of HIT software and services (there are about 100 categories, specific to healthcare). KLAS publishes dozens of provider-driven, provider-centric research reports per year. The site is free to providers in exchange for their willingness to share their vendor experiences with KLAS researchers.
Once it is determined that a vendor’s performance should be measured, KLAS engages that vendor for a complete client list of all live customers. KLAS researchers then reach out to these providers for candid, anonymous feedback and conduct in-depth interviews with these real-life vendor clients. This information is evaluated and published in an online performance database. According to KLAS, “[we don’t] make recommendations; we share the data and let the research speak for itself.”
There is also an annual “Best in KLAS” designation of one vendor within each category based on the research data. Thornberry’s homecare and hospice EMR received the top score once again in the 2019 Best in KLAS: Software & Services Report, surpassing the average for homecare EMR vendors by more than 15 points.
Capterra and Software Advice share user reviews. Both are subsidiaries of Gartner Inc. and are free for providers. Capterra offers verified reviews on thousands of software vendors in more than 700 categories (everything from accounting to yoga studio management). Software Advice offers reviews of software vendors in more than 550 categories covering a wide range of industries.
Capterra and Software Advice publish both unsolicited reviews and solicited, incentivized reviews, but both sites advertise a rigorous review validation process and the assurance that all reviews are verified, unbiased, and independent of vendor membership status.
The two sites also offer product/vendor searches based on the software criteria specified by vendors in their listing profile. Providers can customize their Capterra software search/match list within a category by product rating, number of users, deployment platform, and relevant features. Software Advice offers a categorized vendor search which can be filtered by specialty, agency size, price point, rating, deployment, and platform.
It’s important to understand the positives and negatives of each online research option. While some sites offer the opportunity for a free category listing to any legitimate vendor, they require the vendors themselves to initiate the listing. Several also limit the listing content for non-paying vendors (i.e., to name only, with no profile or links), which in turn limits the match opportunities for both vendor and provider. The sites that provide you with a list of qualified EMR software options may do a wonderful job of matching your needs with potential vendors, but you shouldn’t assume that the list of vendors is comprehensive, as paying vendors may have an edge in getting noticed.
KLAS is the exception; software vendors are included on the KLAS site when they have been identified by industry providers and/or KLAS researchers as valid players in the relevant healthcare market. Vendors can not choose whether they appear on the KLAS site, and they do not pay for any listing.
Other Online Research
Online industry publications can be valuable in your search, as well. There are many good online sources for home healthcare news and insights, and many publish vendor press releases and/or include relevant paid advertising by potentially good-fit EMR vendors.
Healthcare at Home: The Rowan Report (formerly Home Care Tech Report) has been gathering, interpreting and delivering news about home care technology, regulations, marketing, and other issues for more than 10 years. Subscriptions to the weekly e-newsletter are free.
Home Health Line, a publication of DecisionHealth®, and The Remington Report have each been published for more than 25 years, offering news on healthcare trends and regulations and business insights, analysis, and planning. Both are available by paid subscription and include digital versions and other online offerings.
Making Your Decision
Once you have a list of qualified vendors that could meet your needs, it’s time to narrow it down. When evaluating the final candidates, you’ll want to review all of the considerations discussed above (“What defines a quality EMR system?”).
At this stage, the vendors’ own websites will be a valuable tool, as well. Look around the sites yourself, but also make sure each vendor you’re considering shows you what content is available exclusively to their provider customers. Look for:
- Ongoing training resources: system training curricula and materials, implementation and training videos, blended learning materials
- Online manuals for implementation, ongoing operation, system administration, and system customization
- Regular online educational resources on industry developments, advancements, and regulations
- Release notes on system updates
- Printable reference forms for clinicians/users: FAQs, system functions and functionality, agency notes, troubleshooting
A Final Word
Perhaps the most important thing to consider when selecting your EMR solution is the vendor’s reputation for customer service. No system has every bell and whistle, and some bells and whistles you won’t even use once the system is installed. But the investment in a new EMR is huge, and you want to be sure the vendor you choose has a service and support philosophy that matches your own.
As the industry and technology continue to change, you want to be comfortable that the vendor you choose will be with you and supportive every step of the way…until a return on your EMR investment has been achieved, and beyond.