How To Choose an EHR

Types of EHRs: Scope

To begin this series of posts, let’s look at a concept I’m calling “scope”. In reference to EHRs, scope doesn’t refer to the number of users a particular EHR has, but rather, to the number of different roles for which it’s designed. For example, a large scale medical EHR needs different roles or tracks for each of the various personnel that might need to add something to a patient’s chart. That could mean, for example, different tracks for scheduling, billing, intake, nurses and other mid-levels, doctors, lab technicians, social workers, etc. Additionally, such EHRs are designed primarily for hospital settings. Doctors who are affiliated with the hospital can typically access the EHR from their office, but the EHR itself was developed with hospitals in mind.

Types of EHRs: The Shared Chart Model

At it’s simplest, digital record-keeping could simply mean a Word doc, Excel sheet or PDF that you’ve saved on your computer, tablet, phone, thumb drive or other type of digital storage device. There are advantages to digital record-keeping even at this elementary level. For example, with digital records, you no longer have to contend with bulging filing cabinets, finding adequate long-term storage, or shredding – all of which are factors with paper health records. Additionally, it’s relatively easy to make backup copies of digital files to guard against some type of disaster, whereas making copies of paper records is costly, both in terms of time and money and also, effectively doubles the number of filing cabinets or other physical storage space you need.

Are Web-Based EHRs Safe?

The most common reason people give for being reluctant to switch to a web-based EHR is safety. When we’re charged with protecting something – in this case, our clients’ records – most of us intuitively feel safer with something we can see and touch; something physical within our own office where we can maintain control of security ourselves. However, despite this subjective sense of safety, Hurricane Katrina taught us all a valuable lesson about the danger of keeping client records on paper. Floods, tornadoes, fires and other types of disasters can destroy paper records in a heartbeat. If you do maintain paper records, at the very least, you should have backup copies of everything – and those copies should be stored at a completely different location – preferably far away from where your paper records are stored.

Why Not Use a Free EHR?

There are a handful of free EHRs and who doesn’t like free? However, before you jump in with both feet, you may want to know some facts. First I don’t personally know of any behavioral health EHRs for private practice that are free. So if you want to use a free EHR, you’re probably going to have to be OK with a medical product that’s been designed for agency use. The cost factor of these types of EHRs has been eliminated, but there are still some reasons you may not want to use them.