With the vast number of electronic medical record (EMR) choices available, doctors may find it a challenge to select the appropriate software that fits the needs of their practice. Knowing what criteria to use when deciding on suitable EMR software can help you find the best choice for your long-term care practice. Finding a suitable EMR software starts by only researching software that is designed specifically for long-term or post-acute care. This is important because long-term care EMR software is customized to deal with the unique characteristics of hospices, skilled nursing, rehabilitation centers and other long-term care and post-acute care facilities. In a post-acute care setting, you frequently have to draw from multiple specialties as you care for patients suffering from a wide variety of ailments. Likewise, long-term care EMR software draws its functionality from EMR systems made for other specialties. For example, like software systems for primary care practices, your EMR should be capable of charting multiple conditions at the same time. It should also be able to integrate with X-ray, EKGs, Holter monitors and other devices, as well as be capable of receiving and analyzing any lab data that may be generated for each patient. Many patients in a long-term care facility may have time-sensitive or potentially life-threatening conditions, so you should make sure that your EMR has a robust alert system capable of providing the appropriate emergency notifications. Additionally, one critical feature that any long-term care EMR should have is the capability of supporting Minimum Data Sets (MDS) and facilitating all reporting pertaining to this regulatory documentation.
At the start of software evaluation process, you should evaluate potential long-term care EMR based on the following criteria:
- Facility Size: Some software is better suited to small long-term care facilities, others to larger ones. EMR software is designed for a certain number and type of user, with scalability in mind. Make sure the software you select is appropriate for the number of physicians and caregivers in your facility.
- Systems Architecture: You can purchase EMR software that is installed directly on your computer servers on-site at your practice (“client-server”) or EMR software that is located in the “cloud” that you access via the Internet (“cloud-based” or software-as-a-service “SaaS”). Some doctors prefer client-server based software since they feel more comfortable with HIPAA compliance when they control all the underlying data on their systems, despite the need to maintain and upgrade these systems periodically. Other physicians choose cloud-based software because it can be accessed almost anywhere through the Internet. However, you are reliant on your Internet connection, so you need to make sure the quality and consistency of your Internet service is high. It is worth reading about all the advantages and disadvantages of each type, to make sure you choose software with the systems architecture that best matches your needs.
- Certification: When selecting your long-term care EMR, you should make sure that it is tested and certified by an ONC-Authorized Testing and Certification Body (“ONC-ATCB”). The ONC (Office of the National Coordinator for Health Information Technology) is the responsible agency for establishing EMR certification standards and certifying vendor EMR products. ONC-ATCB certification assures that your EMR has met required Meaningful Use (“MU”) objectives and measures. This is a prerequisite to obtaining MU Medicaid (up to $63,750) and Medicare (up to $44,000) incentives for adopting an EMR, and avoiding penalties for not adopting one. To learn more about these topics, you may want to read the following articles:
Unique Features of Long-Term Care EMR Systems
Once you have narrowed down your EMR choices based on practice size, systems architecture, and certification, you can evaluate certain features that are unique to post-acute care facilities.
Such features include:
- ICD/CPT codes specific to long-term care
- Integration with Holter, EKG, X-ray, and other diagnostic equipment
- Built-in interface with labs
- Capability to calculate and support Minimum Data Sets
- Ability to evaluate multiple conditions/complaints
- Care planning facilitation
- Early intervention / detection features
- Capability of reporting on wounds, falls, skin condition, etc.
Pre-designed Templates of Long-Term Care EMR
Long-term care EMR vendors understand that not all specialties are alike. While there are a lot of similarities shared by all EMR software, you should be able to customize whatever EMR you choose to fit your specific needs.
To facilitate this, long-term care EMR vendors offer a variety of pre-designed templates such as ones tailored for:
While selecting a long-term care EMR may seem like a daunting task, having familiarity with the basic selection criteria common to all EMR software as well as some of the features customized for your specialty can help you make the right choice for your facility.