Behavioral Health EHR Must Ask Questions 2.0

It All Begins Before You Start Demos

• The research and demo process can tell you almost everything you need to know about an EHR vendor. Do you have the time and the staff to traverse this rocky road on your own?
• If this isn’t your first rodeo with an EHR, work with vendors that have nothing to hide
• Avoid vendors that shout out in their marketing material how honest they are, would never hold your data hostage, etc. – professionals don’t need to make these claims in their material
• There’s a diagnosis code for this kind of behavior

“Me thinks he doth protest too much” – William Shakespeare

• True professionals simply focus on creating great software with their wing of in-house developers and clinicians
• You have a problem? Some vendors WILL solve it. How much pain, time, and money will it take to create solutions for your organization?
• Smart vendors say NO sometimes
• Are you buying a Yugo that looks like a Ferrari because of a slick marketing agenda?
• Are you buying a Yugo that looks like and runs like a Yugo because it’s “inexpensive” but boasts a lot of features? (This will cost you more in the end)

How We Vet an EHR – The Dreaded RFI

Our guiding principle is “Trust, But Verify”

• Sales demos can represent a vendor’s best marketing efforts
• Sales reps will explain everything s/he wants you to know
• References must be current and include an experienced user base, but they don’t (necessarily) give you the real picture 
• An adviser can share what is going on with all the vendors in the marketplace because we’ve studied them
• Go beyond the vendors “sales speak”.  An adviser can ask and get answers to questions that no agency can
• What tools should your organization use to create a unique request for information? 
• Where did your vendor selection come from? 
• Consulting agencies like MTM Services and everythingEHR can help and often work in tandem to serve the needs of the agencies and EHR vendors that come to us for much needed support

Who Created the Product and Why?

• Is a founder of the EHR a clinician using the product in their own successful Behavioral Health organization?
• Is a founder of the EHR a degreed software engineer?
• How can you document a vendor’s company profile?  LinkedIn is a great place to start
• Staff profiles and credentials in Behavioral Healthcare – Is the EHR vendor staffed by YOUR peers?
• Staff size – how many actual employees work for this vendor?
• What is different about what they have to offer the field of behavioral health?
• Are they doing the “we’ve got features” dance with technology that is over a decade old?
• Founding owners are major contributors in the field of Behavioral Health – such as invited presenters at events like National Council for Behavioral Health
• Staff are recognized leaders in Behavioral Health: authors, counselors, certified billers and coders, former insurance auditors, etc. 
• Quality leadership attracts qualified personnel

Who is the Face of the Company?  What is their Representation?

• Is the CEO a speaker at national conferences about Behavioral Healthcare Technology, an invited guest on radio shows, or the author of multiple publications in Behavioral Health?
• Is the CEO front and center in their marketing material?
• Has the CEO built the EHR company to be comprised of multiple vendors selling and supporting the product or are they staffed appropriately for the size of all of the agencies using their EHR?
• Has the CEO been able to acquire funding to enhance their product?
• Is there a Board of advisors/directors that actually use the product on a daily basis, meet regularly to enhance the product, are industry experts specific to Behavioral Health or are they a random group of people added to a small vendor’s website in order to look like a larger organization?
• Is the product Behavioral Health specific?

Where are their Dollars Spent?

• On Capterra, Software Advice, Technology Advice (All great lead generation organizations where EHR vendors pay a premium to be listed so you -the agency/provider – will find them), Google Ad Words and/or on development of their product
• Engaged with pending law suits against their company 
• Pushing a nonsensical marketing agenda
• Leaving a trail of vendors and users that have tried, and failed, to work with this company and its software
• How important is supporting the solo provider vs. multi-county agencies?
• Cleaning up poor reviews of their product, such as multiple complaints of “slow loading” on public sites, with the EHR vendor blaming agencies for having slow Internet?
• Leaving agencies without the ability to bill a single claim in over a year but still able to obtain a great testimonial from the agency in exchange for free services?
• Forcing agencies to pay monthly and on-going fees when they leave a system while claiming publicly they “never hold data hostage”?
• Adding features already in most products – playing catch up with their technology vs. trail blazing new initiatives involving coordination of care, primary care integration, etc?
• Booths at conferences which is a costly endeavor for any EHR vendor. A booth at a conference is not an endorsement of a product. Should that funding be spent on rewriting an overly done product that was created using technology that is over a decade old?

How Current is Technology?

• Is product browser-based or web-based? 
• Will it meet CCBHC requirements, integrated care, etc. with the same new technology that general EHRs are using (browser-based tools developed in the last 3 years)?
• Does it need to be installed on every device for optimal use?
• How many times has the software program been rewritten since initial creation?
• It Doesn’t Work if You Can’t Click It! – Are users expected to adjust screen resolution to fit the EHR or has the vendor developed a product that auto-adjusts to EVERY device? 
• Can the program be used optimally on all mobile platforms and popular browsers (Cross-Platform)?
• Beware of extra fees for the functionality you need. Windows platforms have gone the way of the typewriter. Look at what has dominated every industry with browser-based solutions (TurboTax, Netflix, Amazon, Salesforce.com, and the general EHR market)
• Can data be extracted easily, such as your clinical notes and demographic data?
• Are they still “pulling and pushing” those 835/837 text files? Direct integration with multiple clearinghouses is a must

Company Trajectory

• How long have they been in the EHR business? Has the company seen a steady increase in its staff size over their tenure?
• Are they positioning to be bought out by a larger, general EHR? If that happens how will this affect your agency?
• Would a general EHR even be interested in their technology?
• The “Whoops!” Factor. Why advisers know which vendors have cost agencies thousands of dollars over-promising and under-delivering despite seemingly great testimonials
• What does their trajectory mean for you – the end-user?
• Are their fewer staff at the EHR than in your own agency?
• Do they have separate departments dedicated to training, support, client satisfaction, and development? 
• Do they have stellar staff who have worked with competitive vendors?
• Have the staff of larger EHR vendors left? Which vendors do they end up working with?

Let’s Compare!

Company A: Founded by clinicians and software engineers

• Steady growth every year. Surpasses the Fortune 100 or Fortune 1000 mark with an excellently staffed organization and stellar credentials
• Rock solid implementations (user renewal rate at 90% or higher)
• Did not start significant marketing campaigns until they were stable enough and their grassroots efforts built a solid user base in all fifty states

Company B: Not founded by clinicians or software engineers

• Organization started around the same time as company A
• Fewer than 15 actual employees to date
• 80% of their budget is spent on marketing and purchasing leads

In whose technology should your organization be involved? Smaller EHR vendors that best serve this market are honest about the size of their organization. Whose organization should have FULL ACCESS to patient mental health records?

It’s Not Always a Vendor Problem

• There are great EHRs devoted to Behavioral Health on the market today
• Perform due diligence using a checklist
• There is no one-size-fits-all EHR for Behavioral Health
• Consult with an independent advocate for your agency, not just the EHR vendor
• Has an adviser ended their praise of an EHR vendor? Ask them why?
• Is your agency culture ready to support an EHR change?
• Is there a sunny side to EHR adoption?

everythingEHR works with multiple venture capital firms answering questions about vendors in the marketspace, multiple institutions that support agencies across the United States, and are invited presenters at national conferences about EHR technology for Behavioral Health. We can help you decide which vendor is going to be the best fit for your agency.

Additional Information:

• Mental Health News Radio
• National Council for Behavioral Health Conference Presentation
• Things to watch out for during a behavioral health sales demo
• The Sunny Side of EHR Adoption
• everythingehr.com/blog
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