Virtually all practices now utilize an electronic billing system. If the practice is satisfied with its billing system, it may be very difficult to change. One of your first decisions will be to determine if you should keep your current billing system or replace it with an EMR that is integrated with a new billing system. This decision should not be taken lightly. If the EMR already has an interface built to your existing billing system, implementation will be much easier and is a viable option. Interfaced systems can and do work very well. If you work with a beta site, however, there will be many challenges to this implementation. Integrated billing and EMR systems usually perform much better, but the entire staff must be retrained.
Explore This IssueAugust 2011
The next phase, a very important one, is to examine the otolaryngology knowledge base. Many systems are designed for primary care and lack content for the surgical subspecialties, particularly otolaryngology. Salesmen will spin this as a great opportunity for you to build your own customized knowledge base. Don’t believe it! You will dramatically underestimate the time commitment necessary to create the knowledge base items and then program them into the EMR. Many companies will offer programming services, but they are quite expensive, usually $150-$200 an hour, with no control over efficiency, costs or deadlines. You are much better off selecting an EMR with a more mature otolaryngology knowledge base. Where are you most likely to find these systems? Start looking at EMR companies that are investing their money and time in coming to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) annual meeting. We are a small surgical specialty, and you will find a handful of companies that are committed to our specialty. Regardless of your choice, you will most likely be dissatisfied with the knowledge base; however, you will be able to adjust a system with an existing otolaryngology knowledge base much more easily than a system designed for primary care.
Next, take the time to understand the philosophies regarding how the system is designed. Does it fit your "flow" of thinking? Does it minimize the work of entering data? You will have to take the time to dig into the system in more depth than you can get in a 30-minute demonstration at the AAO-HNS annual meeting exhibit hall. Consider webinars with the company, for example.