Investing in Electronic Medical Records (EMR) for a medical practice represents a significant decision for any clinician. My own experience with EMRs began about three years ago when I went into private practice. I used one EMR for roughly a year and switched to another due to a variety of persistent frustrations ranging from interface to support. The system I currently have in my office is NexTech. Since I made the switch, I have been much happier with how my EMR is integrated into my practice.

We all know that what works for one clinician may not for another, as we all have different methods of practice and approaches to running our practices. Reflecting the diversity of these approaches, the growing variety of EMR systems on the market offer distinct features that cater to the unique needs of clinicians. While a broader selection of systems should be considered a positive thing when setting out to select an EMR system for your practice, it also has the potential to create more confusion. In light of my two very different experiences with two different systems, I have learned that selecting the right system comes down to asking the right questions and understanding what you value as a practicing physician. Ahead, I will address several areas you should consider when searching for an EMR, whether you currently run your practice through mostly paper records or are considering switching from another EMR system.


Data transition and ownership. One of the most important areas of consideration should be how a system is able to translate your current records, paper- or electronic-based. Learning specifically how a company can convert all of your data is critical, as some formats may not accommodate full conversion of data. Also, you should find out if any costs are associated with access to old data. Some EMR companies own the rights to your data, which is why it is essential to ensure that your data will be able to be transitioned easily. This is important whether you are thinking in terms of getting your paper data converted or if you are thinking ahead to if you wanted to switch to another EMR. Ensuring that your data is yours is important for any practicing clinician.

Startup. Physicians who already have some familiarity with EMRs might want to incorporate their new system in an all-encompassing manner, but those newer to the process may want a slower roll-out and transition period for EMR implementation. Therefore, it's important to determine the speed at which you wish to integrate your system and how accommodating an EMR company will be to your wishes. Some EMR systems are implemented in one way, while others offer separate interfaces for practice management and EMR, which would perhaps allow your staff members to orient themselves to the system.

IT Support. Although the issue of IT support may seem minor in the scope of your EMR use, it can have a significant impact if and when you should ever have difficulties or problems with your system. That's why I recommend getting as much information as possible on the availability of IT support from a given company. Knowing that you can have immediate assistance if needed is assuring, especially if it is already prewritten into your contract. Enduring a laborious process of logging a complaint and waiting to hear back can take hours or possibly days, so it is important to understand your tolerability for these types of things and learn as much as possible about IT support processes.

Customization. Having an EMR system that's customized to your liking and standards may seem like a minor detail, but how your system looks and feels to you and your staff can be the difference of whether it will work for your practice or not. Some EMR systems have all the bells and whistles you could ask for, but if it's not presented in a visual way that's conducive with your sensibilities it will be cumbersome to navigate and ultimately not worth your investment. Some systems will offer a one-size-fits-all format, which you may be able to sample to see if it works for you. It's important to learn how “customizable” a system is, both in terms of formats and interface.

Every system is going to take time for you and your staff to adjust to; taking time to learn what works for you and what doesn't and moreover the extent to which an EMR is customizable to your standards should greatly increase the likelihood that you will find the right system. For example, I am so familiar and satisfied with how my system is set up and presented that I often have very few notes to sign at the end of the day because the templates are easy to navigate and complete quickly by my staff.

Think Ahead. I find it important also to select an EMR provider that is committed to dermatology and can offer some semblance of security that the company will continue to grow. Even though you can't be assured of the future, it's important to ask what will happen to your data in the event that the company may fold. It may be unlikely, but you should know.


There is no right way to go about selecting an EMR provider. There are many different products on the market; all have relative strengths and weaknesses. Remember the importance of asking the right questions and thorough research, both in terms of a system's medical capabilities and its more practical aspects. It is worth the extra time to make the best decision for your practice, your patients, and yourself.

Dr. Sobera is Director of Village Dermatology in Birmingham, Alabama.