21 Questions for an EMR Vendor

Their answers can help you in selecting a system

21 Questions for an EMR Vendor

Their answers can help you in selecting a system.


Most ophthalmology practices have been dragging their feet in regard to implementation of electronic medical records (EMR), with retinal practices a notable laggard in this regard.

There are 2 good reasons why retinal practices have been reluctant to make the transition. First, retina-only practices tend to be smaller than general ophthalmology practices, thus they are unable to achieve the overall economies of scale that larger practices can obtain though staff-related efficiencies. Second, retina practices have specific needs for sophisticated drawing, imaging, and referral letter programs that the major EMR vendors have only recently begun to address. The good news is that some EMR vendors that focus on ophthalmology-specific systems are now offering excellent programs designed especially for retina practices.

Now that Congress has mandated EMR implementation for medical practices — with bonuses for adoption beginning in 2011 and penalties for noncompliance starting in 2014 — retina practices that have not begun planning for EMR implementation would be wise to begin to do so.


Every ophthalmology practice that has implemented EMR will attest to the fact that this practice-transforming change requires the enthusiastic buy-in of all staff members. This process should begin as soon as planning starts.

One good first step for a potential EMR purchaser is to gather key staff members together several weeks before a major ophthalmic meeting where EMR vendors will exhibit and hold a brainstorming session regarding the EMR requirements of the practice. What does the practice want in an electronic records system? Will the existing practice management system need to be replaced? What diagnostic equipment needs to interface with the EMR system. How will physician and staff training be conducted? What kind of implementation costs can the practice expect? What has been the experience of other retina practices that have implemented EMR?

If many questions remain unanswered, it is probably a good idea to consider bringing in an independent outside consultant to help in choosing a vendor and with the implementation process. Practices that have implemented EMR say that going this route is usually money well spent.


Because many of the well-recognized EMR vendors attend the major ophthalmic meetings, these meetings are the place to question vendors and determine which of them might be a good fit with your practice.

The more physicians and staff members who can participate in interviewing vendors, the better chance that the practice will have in obtaining overall buy-in for EMR implementation. Your independent consultant (if you have chosen one) should also be a part of the vendor selection process, whether in person or in evaluating the information that the practice obtains from the vendor interviews.

The adjacent page provides 21 key questions that independent consultants recommend asking to any vendor that you interview. Independent consultants say that any EMR vendor must be able to answer these questions in a way that satisfies the practice.

Clearly, you will have many additional questions specific to your practice, but if a vendor can answer these 21 questions to your satisfaction, that company is probably worthy of further consideration. RP

Questions to Ask When Considering an Electronic Medical Record-keeping System
Compiled by the staff of Retinal PHYSICIAN

You may wish to clip this page and bring it with you while attending this year's Retina Congress or AAO. We suggest making additional copies and asking each vendor to fill it out, or use it as a basis for your discussion and take notes yourself. Happy hunting! — The Editors

1. Will you provide us with the names and contact numbers of other retina practices that have installed your company's system? (If the answer is no, the interview should be over. But if the answer is yes, retina practices that have already implemented that company's system are in the best position to answer key questions about overall cost of installation, staff training, and potential glitches.)

2. What features that are specific to the needs of a retina practice are incorporated into your system?

3. Can the system be customized and modified as new tools and techniques enter our practice?

4. What specifically can you offer us in terms of a drawing program?

5. What specifically can you offer us in terms of storing, retrieving, and transporting images?

6. What specifically can you offer us in terms of generating referral letters?

7. Can you provide a list of diagnostic instruments that automatically interface with your system?

8. What security features are incorporated into your system or are compatible with your system?

9. What anti-failure or back-up safeguards are incorporated into your system or are compatible with your system?

10. What are the weakest areas of your system and how do you intend to improve them? Do you have a record of providing easily installed improvements and upgrades to your retina-specific programs?

11. How can your system help our physicians eliminate dictation?

12. How can your system help us in improving our coding practices and maximizing reimbursement?

13. How can your system make us less vulnerable to audits?

14. We have plans to eventually expand the practice. Is your system designed to interact easily with satellite or remote locations?

15. We are a rather small retina practice, with 3 physicians and several staff members. We cannot really generate many economies of scale, so can you provide us with some physician-related efficiencies that your system can create?

16. Approximately what would be the cost of implementing your system in our practice?

17. How rapidly can we enter specific, detailed, clinical findings into the record and how quickly can we find the information needed to make a clinical decision or develop a treatment plan?

18. What problems, if any, might we encounter in transitioning the records of our existing patients?

19. Can we continue to keep our existing practice management system? If so, will the transition to EMR be easier or more difficult?

20. How can your system streamline practice workflow and improve patient services?

21. How much physician and staff training do you provide and how much do we need to do inhouse, or with the help of an independent consultant?