Choosing an EMR vendor

Issue: BCMJ, vol. 51, No. 2, March 2009, Page 57 Physician Information Technology Office

If you are thinking about choosing an electronic medical record (EMR) vendor for your office or clinic, it’s never too early to start thinking about what you will be looking for and how you will make this important decision.

Before selecting an EMR, it makes good sense to develop a clear understanding of what EMR elements will be crucial for you, your staff, and your patients. Your research, preparation, and planning before choosing a vendor will greatly improve your chances of successfully converting from paper-based to electronic medical records, or changing EMRs. Analyze your needs prior to meeting with EMR vendors, look at the different EMR options, and discuss experiences with your peers. Be sure to include your staff in this process as they will use the EMR as much or more than you each day. Seek their input in differentiating what factors fall in the must-have, nice-to-have, and something-you-can-live-without categories.

Remember to look beyond the obvious when selecting the EMR vendor that will be best for you. Dr Andre van Wyk, of Fort Family Practice in Fort Langley, knows you have to both look in depth and look ahead. “I would suggest looking at the short-, medium-, and long-term goals of what you want the EMR to deliver once it is implemented. For example, can it be easily configured to perform relevant searches in your practice to find gaps in care for diabetics, Pap smears, and so on?” Create a list of the specific things that are most critical for you, and take that list shopping with you.

Look beyond the software functionality itself. Create a list of questions for all potential vendors, including asking about their unique approaches and experience in implementing, trans­itioning, training, and ongoing support. These things are often just as important, or even more important, than the software itself.

Be careful to firm up quotes and be clear about what you are getting. You do not want surprises later. For example, if you are in a practice setting that may require a non-standard pricing model, such as complex group practices, make sure you establish a model that will work both now and in the future. If you require additional interfaces, such as lab results from a local hospital, it is better to confirm that cost up front. Most importantly, wherever possible, write all these items into your contract to avoid misunderstandings later. Make sure you are achieving an apples-to-apples price comparison between vendors, and remember that the words free and cheap often mean different things.

If you are converting from one EMR to another, find out more about the vendors’ conversion capabilities. Dr van Wyk suggests, “Get a clear idea of both the cost and usability of transferred data.” Find out whether you will receive coded data (e.g., a drug is recognized as such by the new EMR), or just text (not nearly as useful, as all such fields will need to be transcribed or attached to the new file manually).

“Ask for a large selection of names (clients), as vendors may only supply names of a couple of infatuated users,” recommends Dr van Wyk. The choice of an EMR vendor will deeply affect your office’s daily routine and the delivery of patient care. Switching to an EMR affects almost everyone connected to your practice. Comments Dr van Wyk, “It’s essential to distinguish between what vendors can reasonably do for you and what they cannot. Vendors are not well equipped (nor can they be expected to be) to deal with the inevitable transitional stresses that both staff and practitioners experience during the implementation phase.”

The evaluation process for the PITO-qualified EMRs has ensured a very high minimum bar of functionality, service levels, reliability, and standardized pricing. However, it is still important to make sure that any unique or optional features you want are provided, you like the user interface, the support model will meet your needs, and you establish an appropriate pricing model. Your PITO local relationship manager can help you to identify the types of things to look for, and you can find more information on selecting a vendor on the PITO web site ( under Plan and Choose.

Most importantly, invest this time up front. The EMR is a tool you will use every day, likely for the rest of your career. Choosing the right EMR for you, and establishing a good contract, will set you up for success in the long term.

—Jeremy Smith
Program Director, PITO

Jeremy Smith,. Choosing an EMR vendor. BCMJ, Vol. 51, No. 2, March, 2009, Page(s) 57 - Physician Information Technology Office.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply