113+ Questions to Ask EMR Vendors
What are the most important questions to ask before signing an EMR contract?
Focus on the seven areas where vendors are most likely to give vague answers: total 5-year cost including price escalation, guaranteed uptime SLA with financial penalties, data ownership and export format if you leave, go-live track record for your specific specialty and practice size, what training is included vs. extra cost, minimum contract term and early termination fees, and data migration timeline and responsibility. Get every commitment in writing as a contract addendum — verbal promises from the sales team have zero enforcement value.
Most EMR demos are carefully rehearsed performances. These are the questions that break through the script — the ones that reveal real pricing, actual support response times, and what happens when the relationship stops being a sales process.
After watching dozens of practices go through EMR selection, the pattern is always the same: the demo looks great, the sales rep is responsive, and six months post-go-live the practice discovers the pricing structure they did not fully understand, the support tier they did not realize was extra, or the data migration limitation nobody mentioned. These questions exist to surface those issues before you sign, not after.
Do not dump 100 questions on a vendor in one meeting — you will get rushed, generic answers. Pick 8-10 per session. Start with Pricing and Contract Terms (those reveal the most about how the relationship will actually work). Send the detailed questions in writing beforehand and require written responses. Verbal promises from a sales rep are worthless once the contract is signed.
Pricing & Costs
Where vendors are vaguest and where your budget will actually go — ask these first
- What is the per-provider or per-user monthly cost?
- Is there an implementation fee? How much?
- What is included in the base price vs. add-on modules?
- Are there data migration costs?
- What are the costs for training?
- Are there interface/integration fees?
- What is your price escalation policy at renewal?
- Are there any transaction-based fees (claims, eligibility checks)?
- What happens to pricing if we add or remove users?
- Is there a setup fee for patient portal?
- What hardware or infrastructure costs should we expect?
- Are there any annual maintenance fees?
- What is included vs. extra cost for support tiers?
Features & Functionality
Test these with your actual workflows, not the vendor's rehearsed demo scenarios
- Does the system have templates for our specialty?
- How customizable are clinical templates?
- What e-prescribing capabilities are included (EPCS)?
- How does the lab ordering and results workflow function?
- What patient portal features are available?
- Is there a mobile app for providers? For patients?
- How does the system handle referral management?
- What reporting and analytics are built-in?
- Can we generate custom reports?
- How does the system support MIPS/MACRA reporting?
- What telehealth capabilities are integrated?
- How does the scheduling module work?
- Is there a patient recall/reminder system?
- What billing and claims functionality is included?
- Does the system support multi-location practices?
Implementation & Training
The go-live timeline vendors quote and the reality are usually 4-8 weeks apart
- What is the typical implementation timeline?
- Who manages the implementation project?
- How is data migration handled from our current system?
- What data formats can you import?
- How much training is included?
- What training formats are available (on-site, virtual, self-paced)?
- Do you offer super-user or train-the-trainer programs?
- What resources are available for ongoing learning?
- How long is the parallel operation period?
- What support is provided during go-live?
- Can implementation be done in phases?
- What workflow analysis do you provide?
- How do you handle customization requests?
Support & Service
Support quality drops dramatically after the sale closes — pin down the specifics now
- What are your support hours?
- Is 24/7 support available? At what cost?
- What is the typical response time for support tickets?
- Do you have guaranteed response times (SLA)?
- How do I reach support (phone, email, chat)?
- Is there a dedicated account manager?
- How are escalations handled?
- What self-service resources are available?
- Is there a user community or forum?
- How often are product updates released?
- How are updates deployed (automatic, scheduled)?
- Do updates cause downtime?
- How are bugs and issues prioritized?
Security & Compliance
Every vendor claims HIPAA compliance — these questions test whether they mean it
- What security certifications do you hold (SOC 2, HITRUST)?
- How is data encrypted (at rest and in transit)?
- Where is data stored geographically?
- What is your disaster recovery plan?
- What is your RPO and RTO?
- How do you handle HIPAA compliance?
- Do you provide a BAA (Business Associate Agreement)?
- How are user access controls managed?
- What audit trail capabilities exist?
- How do you handle security incidents?
- When was your last penetration test?
- What cyber insurance do you carry?
- How is PHI handled during support sessions?
Integrations & Interoperability
Integration fees and timelines are where budgets blow up — get specifics in writing
- What standard integrations are available (labs, imaging)?
- How do you support HL7 and FHIR?
- What HIE connections are available?
- Can you integrate with our billing system?
- What pharmacy networks do you connect to?
- How are third-party integrations handled?
- Is there an open API?
- What is the cost for custom integrations?
- How long do integrations typically take to implement?
- How do you handle integration maintenance?
- What immunization registries do you connect to?
- Can you integrate with patient engagement tools?
Contract & Business Terms
The exit clause is the most important part of your contract — read it before you sign
- What is the minimum contract term?
- What are the terms for contract renewal?
- What is the cancellation policy?
- What notice is required to terminate?
- Who owns the data in the system?
- What data export options are available?
- In what format can data be exported?
- What happens to our data after termination?
- Are there any auto-renewal clauses?
- What liability limits are in the contract?
- What uptime guarantees are provided?
- Are there performance penalties for SLA breaches?
Company & Stability
A vendor acquisition or pivot can strand your practice — assess long-term stability
- How long have you been in business?
- How many customers do you have?
- What is your customer retention rate?
- Are you profitable or VC-backed?
- Have there been any recent ownership changes?
- What is your product roadmap?
- How do customers influence product direction?
- What percentage of revenue goes to R&D?
- Who are your largest customers?
- What customer segments do you focus on?
- Are there any pending lawsuits or regulatory issues?
- What is your planned growth strategy?
References & Proof Points
Vendors hand-pick their best references — here is how to get honest ones
- Can you provide references in our specialty?
- Can we speak with practices of similar size?
- Can we speak with recent implementations (last 6 months)?
- Can we visit a customer site?
- What case studies are available?
- What is your average implementation success rate?
- What is your Net Promoter Score (NPS)?
- Do you have customer satisfaction survey results?
- Can you share any ROI studies?
- What awards or recognition have you received?
Bring This to Your Next Demo
Print this checklist (Ctrl+P / Cmd+P) and bring it to vendor meetings. Having the questions in front of you keeps the conversation on your terms, not theirs.
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