How to evaluate EHR vendors (with free matrix)

Your electronic health record (EHR) system is the lifeblood of your practice. The right system helps you improve your practice’s efficiency, improve the quality of care, and simplify the compliance process.

However, on the flip side, if you choose the wrong EHR vendor, you could quickly pay more than you expected with little to no returns in the long run. You could add more complexity to your current workflows, making it harder to work with the EHR than without.

When considering the long-term nature of EHR investments — often spanning a decade or more — it’s critical to make the right decision.

In this article, we’ll explain the criteria you should use to evaluate EHR vendors and offer a vendor evaluation matrix to simplify the process.

One of the main challenges practice owners face while evaluating EHR vendors is the sheer number of options available these days. It leads to analysis paralysis, making it harder to switch providers even if they want to.

The process requires significant time because you’ll have to conduct research, sit through multiple demos, and review various proposal requests (RFPs). When time is a constraint, you need a solid process to get through it quickly while making the right decision.

Another challenge they face is the inability to accurately assess the usability of these EHR systems. When you’re presented with too many options — all seemingly similar — it’s challenging to assess how they’ll work with your existing systems.

In this case, you need to do 2 things: take an EHR readiness survey and take stock of existing tools. The former will tell you if it’s truly time to change EHR providers and if your team is ready to allocate resources. The latter will tell you which EHRs to prioritize as it should integrate with your existing technology stack.

Here’s an EHR readiness checklist you can use to get started:

Practice owners also struggle with evaluating vendors using strict criteria. Because there are many considerations to account for, you need a standardized list of requirements to make a fair and accurate assessment.

Here’s what you should consider.

Your EHR’s features significantly impact its utility to your practice. There is a standard set of features you get, like:

However, there is additional functionality that could improve its use — for example, appointment scheduling features, in-built automations, and robust reporting capabilities.

It depends on whether you use modular or full EHR systems. The latter comes only with the specific components you need, but if you’re serious about implementing an EHR, consolidate your tools and systems with a full EHR system.

Tebra’s 2024 EHR report found that 45% of providers ranked usability and customization as the top essential feature. And for good reason. If you don’t get basic customization capabilities that let you modify the EHR to fit your workflows, it’s a wasted investment.

This is especially true if you’re running a specialty practice that has specific billing and insurance requirements. Or if you need diagnostic and e-prescription support specific to certain fields of medicine. So, identify what your practice needs and see if EHR vendors offer some level of flexibility during implementation.

The EHR should fit your needs, not the other way around. Unfortunately, our survey found that 32% of providers wouldn’t recommend their EHR provider, with the lack of robust integrations being one reason.

We found that practice owners require the following integrations for their EHR the most:

In addition, to improve the EHR’s functionality, consider compatibility with local or regional health information exchanges (HIEs) and the availability of a marketplace.

An EHR could cost you tens of thousands of dollars annually, barring the implementation and support costs. Avoid thinking of it as an annual or one-time cost, as the total cost of ownership (TCO) could exceed your expectations.

Here are a few things to account for:

Inquire about the payment plans. Some vendors only offer annual billing, while others offer a monthly subscription model to spread the costs.

Assess the investment based on long-term returns. As the EHR should help you increase efficiency through benefits like high patient throughput and coding accuracy, these could take time to show impact.

A vendor’s reputation and track record are crucial parts of the consideration process. Look for indicators like good/stable financial performance, awards or recognitions, certifications, and credibility in the industry.

Another way to assess a fit is to review testimonials or case studies from customers who’ve been in your shoes before. For example, if you have a mental health clinic, ask the EHR vendor if they’ve previously worked with similar customers. This way, you’ll know that their EHR would be better suited to your needs.

Also, it’s worth checking if they’ve been involved in any significant controversies or legal issues. Such issues could arise due to billing policies or data security issues, so we recommend looking into this beforehand.

Data security and compliance are two non-negotiable aspects of working with an EHR vendor. With the rise in data breaches and potential legal liabilities due to it, you need to make sure the EHR vendor is certified as per regulations like:

Ask them about the uptime guarantee percentage as well. Ideally, it should be above 99.9% — which indicates the system’s high availability. In the event of a system outage, they should also have appropriate disaster recovery and business continuity plans.

Evaluate the vendor’s approach to software updates and upgrades. Do they offer regular updates, and will it impact your day-to-day activities if they do? In some cases, you might need to re-train staff to adopt these changes, so ask the vendor if they offer technical and training support.

Inquire about their support hours, contact methods (phone, email, chat), and guaranteed response times for different issue severities. If you need to customize your workflows or troubleshoot something, ask if they offer consulting services. These might result in additional costs, but the promise of ongoing support will be worth it, as it could take you months to implement a new system.

Independent practice owners spend nearly half of patient time on EHR documentation. Your new EHR provider should help you drastically reduce this number. 

Let’s look at how you can start the EHR selection process:

Unless you evaluate your current systems, you won’t know what to look for or the true reasons you’re looking to switch EHR vendors.

Our survey found that 41% of providers consider switching EHR vendors when they notice a rising need for staff training. Talk to your staff members and find out why they’re struggling with the current EHR, which features are the hardest to adopt, and what they expect from the new EHR.

Here’s a need assessment template to help you get started:

Next, list your practice’s specific requirements, such as patient volume, medical specialty, and billing processes. Your new EHR needs to fit right into these needs, so make a list of “must-have” features before starting your search.

In this stage, finalize an approximate budget for EHR implementation as well so that you can shortlist vendors accordingly.

In this step, start finding EHR vendors through sources like:

First, cast a wide net and look for as many vendors as possible. This will give you a broader pool of vendor options so you don’t feel stuck with only the well-known.

Document your research in a spreadsheet. We recommend creating a vendor rating sheet where you list your must-have features and assess vendors accordingly. It prevents bias while you’re deciding. Ensure you use the criteria provided in the previous section to evaluate vendors.

Aim to narrow your list down to a maximum of 10 top contenders. This number is manageable while providing a good range of options.

Once you’ve shortlisted vendors, contact them for a demo. This typically starts with a request for demonstration (RFD) document where you explain your practice’s background and needs. Remember to include practice-specific scenarios to help the vendor understand your current issues.Pay attention to the features, user interface, and workflows during the demo. Also, include a staff representative (end-user) in the process so that they can ask the right questions. You can use this checklist of questions to ask ehr vendors during the demo:

Another question to consider is how data is handled if your practice is acquired or sold. 

After each demo, hold a debrief session with your team to discuss first impressions. Document your findings in the vendor rating sheet so that you can make objective comparisons.

Along with a demo, you can also see if any of the vendors offer a free or discounted trial before full purchase.

Within your vendor rating sheet, list your must-have features and critical criteria, such as functionality, ease of use, vendor support, cost, etc. Assign weights to each criterion based on its importance to your practice.

For example, you might consider cost a bigger factor than the rest. Use a consistent rating scale for each criterion—for example, a scale of 1 to 5, where 1 is poor, and 5 is excellent.

Here’s a vendor evaluation matrix you can use: 

Next, bring in your buying committee (physicians, nurses, administrative staff, IT personnel) and ask them to independently rate each tool. Sum up the scores and see which vendor scores the highest.

However, don’t rely solely on the numbers. Use the evaluation matrix as a starting point for a deeper discussion about each system’s pros and cons. Look at factors that aren’t easily quantifiable, such as the overall impression of the vendor’s culture and values and how well they align with your practice.

Use the matrix to shortlist three vendors and conduct a final due diligence round. For example:

Once you’ve chosen your vendor, it’s time for implementation.

Choosing an EHR vendor can seem like a challenging task, but with the right approach, you’ll be able to make an informed decision faster.

You should use a vendor comparison sheet to compare vendors objectively. However, to take a more holistic approach to the process, you should also consider “soft” factors like vendor response rates, confidence, and service credibility. Download our EHR selection and implementation guide to learn more.