Tools & Resources
What to Keep in Mind When Choosing an EHR System Choosing an electronic health record (EHR) system for your practice can be a daunting and overwhelming task. There are many aspects to consider and getting information to help you navigate many vendors and their offerings can be difficult. The AAN has come up with questions and topics you should be asking of an EHR vendor before signing on the dotted line. Here are some items to consider regarding your practice setting, provider documentation preferences, data hosting, and questions to ask regarding transmitting and receiving data from third parties, and meeting government reporting requirements. There are a variety of systems from which to choose and not all are perfect for your practice. Deciding on things that matter most to your practice is an important first step. Would you like a comprehensive EHR that is used by many different practices in your area, or would you like a smaller niche EHR that caters exclusively to smaller practices? If you choose to go with a smaller EHR, be sure to decide if you’d like billing software and clinical information handled by the same system. The chair of the AAN’s Practice Management & Technology Subcommittee, David A. Evans, MBA, recommended, “When considering vendor size, take into consideration the service and resources a larger vendor may have in product development and balance with the advantages a smaller vendor may provide by being niche and nimble. Having colleagues in the same specialty and in your region may provide some advantages in optimizing functionality of the system.” Subcommittee member Melissa Yu, MD, agreed. “A larger vendor will have more resources for research and development, may have more options for integration with other service, and even have more online self-help. A larger vendor may also service your local hospitals, allowing you to view inpatient records without leaving your office EHR system. A larger vendor may be costlier, however, and more difficult to customize for your specific needs.”
Asking the EHR representative before selection helps to avoid issues later. Some of the most important things to consider when selecting an EHR are understanding who owns the data, what Yu it can be used for, and if there are fees associated with sending data to third parties. Do you have enough resources in your practice to maintain a server for your data on-site or would you prefer that the EHR handle your data and keep it stored in the cloud? Cloud-based systems are generally cheaper and require fewer resources to operate, but before selecting this option you should discuss data access. Once data is moved from a local server into the cloud, you may have to pay a fee to export data for local use or to send it to a third party, such as a registry. Some AAN members have reported difficulty integrating with the Axon Registry ®, an AAN-sponsored clinical data registry for quality improvement, because of issues with data ownership and transfer. Find out more about EHR integration with Axon at AAN.com/view/Axon. Also, consider bandwidth needs for cloud-based systems, depending on practice size, and back-up methods in case your internet connection goes down. Consider how you will submit data to CMS programs such as the Merit-based Incentive Payment System (MIPS). Many EHRs will submit MIPS data on behalf of practices, but only on specific measures, or with additional costs. While selecting an EHR can be an intimidating task, there are many resources available to help. The Office of the National Coordinator for Health Information Technology has created resources regarding selecting and implementing an EHR system. You can check them out at Healthit.gov/playbook. If you have questions about topics to cover before selecting an EHR, please email practice@aan.com.
Thinking about the way you enter clinical data is also important. Do you prefer to write a narrative about the visit or use templates? Some EHRs provide ready-made templates for progress notes or easy ways to create them; others don’t.
AAN Publishes New Patient Book on Migraine The AAN has published a new patient education book on migraine and other headaches. Authored by William B. Young, MD, FAHS, FAAN, and Stephen D. Silberstein, MD, FACP, FAHS, FAAN, Navigating Life with Migraine and Other Headaches dispels common misperceptions about migraine and offers practical advice for patients. The 216-page book is available through all major booksellers and at BrainLifeMag.org/Books.
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AANnews • July 2018