The information provided below is a sample of important considerations related to how your practice will be using an EHR. A complete checklist for review is available in Evaluating and Selecting an Electronic Medical Record System (revised October 2004) available through Outlook Associates, Inc.
| Where will the system be used? |
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- In multiple office locations
- With multiple users simultaneously
- Open multiple encounter records at the same time on one patient
- Open multiple patient records at the same time
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| Which workflow management tools will you need? |
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- Provider schedules
- Prioritized task list by user
- Method to track patient visit status on-screen
- Customized workflow by provider/clinician
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| Is the practice management system integrated or is an interface required? |
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| Are there other interfaces available (lab, radiology, etc.)? |
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Electronic payer connectivity, support for HIPAA standards for electronic transactions, support for HL7 interface standards |
| How will you be documenting encounters/information? |
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Notes templates, customized templates (be practice or provider), free text option, drop down lists, check boxes, speech recognition, anatomical drawings, free-hand sketches, scanned images, video imaging, etc. |
| Do you wish to track episodes of care, risk factors, or care processes? |
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| Do you want support for error checking within data entry? |
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| What types of result reporting documents do you require? |
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- Chart notes for visits, phone calls
- Emergency room reports
- Laboratory results
- Radiology reports
- Consultation reports
- Discharge summaries
- Medication lists
- Allergy lists
- Problem lists
- Growth charts
- Patient telephone messaging
- Vital signs, i.e., Blood pressure lying, sitting, standing; Pulse: oral, radial, pedal, femoral; Temperature: Fahrenheit, Celsius; Height: feet / inches, centimeters
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| Do you need to generate forms? If yes, what forms do you require? |
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| Is it important to be able to modify these forms / letters by provider, practice or location? |
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| Do you want to create custom forms for any purpose? |
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| How will information from the EHR be displayed in addition to text? |
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Tables, flowsheets, graphics, free-hand drawing, stored images. |
| How easily can the EHR be searched? |
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- By patient identifiers such as health plan member number, patient name, social security number (patient’s or responsible party’s), or account number.
- By date, problem, text, or encounter type
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| What prompts or reminders would you need or like? |
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- Unfinished patient chart documentation
- Spellchecking
- Provider alerts for missing charting elements
- Electronic team messaging
- Care management, disease management, or prevention (may include clinical decision support tools, reports, and reminder systems)
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| Does the practice want to have clinical decision support built into the system? |
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| Is it important to have support for medication/prescription writing? |
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Examples include a drug database, formularies linked to patient benefits, dosage algorithms, drug-allergy checking, drug-drug interaction checking, drug-food interaction checking, weight-based dosing, prescription renewal, co-signature required based on security, fax and remote printing of prescriptions
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| Would your practice need functions to support order management? |
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Examples include on-line ordering, order cancellation, automatic suggestion of orders required to satisfy protocols, notification to provider for tests not completed within specified time frame, trending and graphing of discrete results data, graphing of results to medications and other clinical data. |
| Would it be necessary to print or transmit all or portions of the patient record? Is the system capable of meeting the need of the practice? |
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| Is it important for the system to support coding or validation of codes related to current diagnosis and procedures? |
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| What are the needs of the practice related to security (signing/authorization and access) and confidentiality? |
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- Considerations include electronic signatures, authorization required for electronic signatures, sign individual sections, records locked after signature, co-signature, authentication required when medications are ordered or when transmitting orders
- Considerations include limited access to portions of record based on job functions, access limited by patient record type, password protection, required password changes, screen time-outs, HIPAA compliant access audit trail
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