EHR investigation

When determining whether to adopt an EHR system, decide what processes the system should improve. The goal is to streamline such functions as gathering data for analysis, calculating bills, and writing prescriptions. Can the system do these tasks more efficiently than they are being performed presently?


Once goals are determined, identify the steps and personnel involved. The transition to electronic records “requires substantial effort, but you really can change the way you work,” said Dr. Maddux, whose practice went paperless near the end of 2003, when the combined urology and nephrology practice had about 56,000 active patient records. It is helpful to confer with other practices about their systems.

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Selection and purchase

Before moving forward with the selection of an EHR system, your partners should agree on objectives and priorities. Assemble a team representing all areas of the practice and establish goals targeting clinical, financial, and operational improvements. The team can help develop a timeline to determine how long the practice will run its old and new systems and how training will be scheduled.


ACP recommends grouping procedures into lists—perhaps dividing them into clinical and business tasks—and comparing them to vendors’ services. You can use this to create a checklist of your purchase criteria, which includes the features that will match the information management needs of your practice.


Your list of personalized criteria can be used to decide which vendors to contact for information, demonstrations, and site visits. Developing a “request for proposal” (RFP) will prioritize issues a practice seeks to resolve and delineate the characteristics of the practice before making a decision.


During the RFP process, it is important to specify what kinds of computers and servers are required. A common configuration is to have PCs in the exam rooms, doctors’ offices, nurses’ stations and at the check-in desk, all linked to a common server. Some practices use wireless laptops in conjunction with networked PCs, allowing the practice to purchase fewer PCs and invest in a wireless network. The practice should take an inventory of its current equipment, understanding that the new software might require updating hard drives and memory.


This information was provided by the Renal Physicians Association of Rockville, Md. (, which has partnered with Renal & Urology News to create this new department. This article, which is the first of two parts, is based on material that appeared first in RPA’s newsletter, RPA News. The second part of this article will appear in the September issue.