How to Complete an EHR System Selection

EHR selection

There's more to EHR system selection thank you might think.

Electronic Health Records (EHRs) have become vital to modern healthcare delivery. They improve the efficiency and accuracy of patient care and provide reduced costs, enhanced patient safety, improved quality of care, and streamlined workflows. However, selecting the right EHR system for your organization can be daunting when considering the cost and the long-term impact the system will have on your business.   

With so many options available, it's essential to have a trusted partner that can walk you through the process and deliver a comprehensive selection that considers your organization's specific needs and goals. This blog will walk you through our extensive EHR selection process we implement with customers, from gathering and documenting requirements to evaluating vendors, defining the solution, creating a total cost of ownership analysis, and more. 

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How to Begin the EHR Selection Process 

EHR system selection and implementation can be complex and time-consuming, but these steps are meant to walk you through the best practices of the selection process to help ensure you’ve chosen one of the best EHR systems for your organization. With over a decade of experience, we’ve broken down the fundamental stages of this process to achieve the best result for the businesses that seek our EHR consulting services.  

Gather & Document Requirements  

You should start by identifying and documenting the specific needs and expectations of the organization. This should be done by thoroughly examining the organization's current workflows, data management practices, and long-term goals.   

It's essential to involve key stakeholders such as staff members, management, executives, clinicians, physicians, and any relevant external partners in this process to ensure that all requirements are considered. 

Evaluate/Assess Vendors  

Evaluating vendors involves researching and comparing different EHR vendors and their capabilities. This could include visiting vendor websites, attending demos and webinars, researching previous client successes and challenges, and getting references from other organizations that have implemented similar systems. 

In addition, organizations should ensure the vendor's solution fits their requirements and can scale with growth, so you're not underequipped five to ten years later, including similar company strategies, alignment with your vendor’s long-term goals, interoperability, new technology development, and an endless list of other items that can surface as the years go on. 

Define Solution  

There are multiple ways to approach a problem, and EHR systems are no exception. That’s why you’ll need to determine which specific EHR solution best meets the organization's needs based on vendor evaluations and the requirements gathered.  

In addition, this step will require a detailed review of the EHR system's functionalities, which may include: 

  • Electronic prescribing: Providers can electronically prescribe medications and view medication history using electronic prescribing. 
  • Clinical decision support: The system provides real-time alerts and reminders for evidence-based clinical guidelines, lab results, and other critical patient information through clinical decision support. 
  • Population health management: Population health management allows tracking and managing patient populations, including identifying high-risk patients and monitoring and reporting on care gaps. 
  • Reporting and analytics: Reporting and analytics enable the generation of reports and analytics on patient outcomes, utilization, and cost. 
  • Clinical documentation: Clinical documentation allows for documenting patient encounters, including history, examination, and treatment plans, and integration with other clinical systems, such as laboratory and imaging systems. 

Additionally, the step will require consideration of customization options and integrations with other systems. This includes evaluating customization options, like adding custom forms, templates, and integrating with other systems, such as laboratory, billing, or scheduling systems. This ensures that the EHR system will work seamlessly with other systems in the organization and provide a comprehensive view of the patient's data. 

Define Scope  

Defining the scope of your project involves outlining the specific goals, deliverables, and timelines for the EHR implementation project. During this phase, we determine which functionalities and data will be included in the system and when they will be implemented. 

Create Total Cost of Ownership (TCO) Analysis  

Everything comes at a cost, but unfortunately the cost isn’t always clear, especially in the long run. During this process, an organization should create a total cost of ownership (TCO) analysis to estimate the long-term costs associated with the EHR system, including hardware and software expenses, ongoing maintenance and support, capital and operating costs over a 5–7-year period, and also your internal costs for resources, which can include training and devices. 

Validate Value Proposition  

The organization must ensure that the chosen EHR system will provide a return on investment (ROI) and deliver the benefits identified in the requirements-gathering phase. 

Determine Sequencing/Timelines 

Next, you’ll need to create a project plan that outlines the specific tasks that need to be completed, the resources required, and the timelines for each phase of the EHR implementation project. 

Create Contingency Planning 

Plan A is great, but there’s no better peace of mind than having contingencies in place in case things go awry. Start by identifying potential risks that could impact the EHR implementation project and creating a plan to mitigate those risks. 

Selecting an EHR Partner 


Start by creating steering and stakeholder teams for this phase of the EHR system selection process, scheduling interviews and walkthroughs, holding kickoff events, and confirming the goals and strategy for selecting partners. A documented escalation process should also be in place to ensure that any issues or concerns that arise during the discovery phase can be quickly and effectively addressed. This should include clear lines of communication and an established hierarchy for escalating issues. 

Finally, establishing management methodologies and change control procedures in place to ensure that the project is executed efficiently and effectively and that any changes or deviations from the original plan are properly managed and controlled. This helps to prevent unnecessary delays and unexpected costs and keeps the project on track to meet its goals and objectives. 


Next, perform up-to-date market research, preparing and distributing end-user surveys, and conducting walkthroughs, interviews, and group sessions to determine the current state of the organization's EHR system and review workflows, open service requests, and enhancements. It also involves determining the desired future state and documenting and prioritizing system requirements. 


Preparation: To prepare for evaluation, you should create scorecards based on prioritized requirements, determining vendors to evaluate, creating RFPs, and scheduling demonstrations.

Conduct EvaluationTo conduct an evaluation, start by reviewing and scoring proposals, attending and scoring vendor demos, conducting and scoring vendor reference calls, and compiling scorecards for proposals, demos, and reference calls. 


This phase brings everything you’ve done so far all together by assessing the scorecards, analyzing workflow and interview data, analyzing service request data, analyzing IT support structure, analyzing vendor customer reviews, assessing vendors' ability to support clinical and business needs, and completing a five-year total cost of ownership model. It also involves conducting resource impact planning and determining IT support structure modifications.

Create results report and document recommendations based on the findings.

EHR System Selection  

Finally, you can review the results of your findings to make recommendations, determine contract negotiation strategy and define high-level project timeline and sequencing. 

These four steps provide a comprehensive approach to selecting partners for an EHR implementation project and help ensure that the selected partners have the necessary experience, references, and resources to support the organization's EHR system effectively. By following these steps, organizations can make an informed decision about which partners to select and ensure that their EHR implementation project is successful. 


EHR system selection for your organization is a crucial decision that requires a thorough and systematic approach. By following the steps outlined in this blog, from gathering and documenting requirements to evaluating vendors, defining the solution, creating a total cost of ownership analysis, and more, organizations can ensure that they select an EHR system that is the perfect fit for their unique needs and goals.   

With the right EHR system in place, organizations can expect significant improvements in the quality of care, operational efficiency, and overall patient outcomes. In addition, a well-executed EHR implementation can be a catalyst for transformation and innovation in healthcare delivery and ultimately bring benefits to the whole healthcare system and the patients they serve. 

Clients from around the country come to us to help them identify and execute the right EHR system for their unique business needs. If you’re looking to implement or migrate an EHR for your business, feel free to schedule a consultation with one of our experts to get started.