With so many EMR vendors to choose from, finding the best solution to fit your facility and your budget is no easy task. Here are 10 critical features your team should look for in an EMR system:

1. Record retrieval. How easy is it to create a complete, printed or portable electronic record? Occasionally you may come across a situation where critical information doesn't appear or isn't accessible in the record. To avoid such situations, develop a "critical content" list and ensure that you can review and report this defined information in the final record. This capability is important, as you'll need to retrieve data from the EMR if you're subpoenaed or if patients and other caregivers request such information.

2. Documentation. Does the record tell the story of the patient's visit from arrival to discharge in chronological order, showing the flow of patient care at your facility? How does it accomplish this? Consider using a charting tool such as DARP (data, action, response, plan) to ensure that this patient care information is systematically recorded.

3. Reporting capabilities. Often overlooked during the EMR evaluation process, reporting is an important component to consider. Don't accept a verbal assurance that all reporting is possible — ask to view specific reports generated by the system, preferably reports you'd frequently analyze, such as days in accounts receivable or OR utilization.

4. Medication verification. Does the system have drug interaction and drug allergy checks? Is it capable of e-prescribing?

5. Customization. Are you looking for a product that you can customize, or one that you can use "out of the box?" If it's customizable, can your organization make the changes, or do all requests need to go through the vendor? Keep in mind that if you choose to customize, this will require additional resources both on the front end and down the road as you make updates.

6. Security. Does the system provide security and privacy functionality to prevent a breach of protected health information? Don't just assume the product is HIPAA compliant — verify that it is.

7. Interface. Is the EMR system capable of a full interface with laboratory or other programs, or is it limited? Some systems will only allow exportation of data, but not importation. Also ask if the EMR can interface with other devices, such as EKG and vital signs monitors or point-of-care testing. Will you have to purchase third-party vendor software to enable interfacing or additional systems and modules to enable full product functionality? Ideally, your EMR will let you share clinical data with other electronic health record systems, such as those used by local physician practices and hospitals, to reduce unnecessary redundancies and improve patient and physician satisfaction.

8. Downtime. How much downtime is to be expected for scheduled maintenance and other purposes? Who determines when this will occur? Be aware that even with comprehensive downtime policies in place, downtime will be challenging for staff, so the more control you have over it, the better.

9. System support. What type of support does the vendor offer? How often and at what hours will this support be available? How is support provided — are technicians available by phone for critical issues? Are maintenance agreements and associated fees included in the purchase price? How often can you expect upgrades, and what costs are associated with them? Request references related to the support services provided by each vendor so you can verify their claims with other facilities that use the systems you're considering.

10. Training. How much training does the vendor provide? Will this training occur on-site, or will your staff have to go off-site to learn the system? Don't overlook the impact of off-site training; consider not only the cost incurred by travel, but also the staffing hurdles it could create back at your facility during the training period.

Beyond the bottom line
Purchasing an EMR system will be a costly endeavor for your facility, but try not to focus entirely on the price tag. For a successful paperless transition, the system has to be easy to implement and use, helping your staff work smarter, not harder. Using the template above, craft questions for prospective vendors that will help you determine which products will meet the established goals and specific needs of your organization. Be sure to ask the same questions of all vendors for a consistent, accurate comparison.

Finally, while this question-and-answer process is important, don't rely solely on what the vendors tell you. Before making your final decision on a product, visit a similar site that is using the EMR. Invite key staff from your facility to attend this visit, and ask specific questions while on-site. Seeing the product in action and talking with frontline staff members who use it will help you to determine if it's a good fit for your facility. Remember, an electronic medical records system is the type of capital expenditure you absolutely want to get right the first time.