EHR customization: How different should specialty EHRs really be?


EHRs for healthcare specialty practices have a lot more commonalities with each other than differences. The core clinical and meaningful use functionality requirements are similar across all specialties, as are an intuitive interface, customizable screen layouts, anytime/anywhere access to a cloud-based system, solid population management and disease management tools, and support for tablets and mobile devices.

We have learned a lot about best practices for physician practice EHRs and these universally applicable requirements should be available to all specialties, complemented – of course – with the specialty-specific functionality each discipline requires. For example, all provider organizations are going to need software for billing and scheduling, but only an optometrist will need software for ordering lenses or contacts. With regards to an EHR, a radiologist will have very specific imaging needs while a podiatrist may not. An EHR platform, by its nature, should be highly customizable allowing specific needs and desires to be met.

I believe that all specialties need a constellation of specialty-specific functionality, but based on general best practices we know work with a robust EHR at its core to drive clinical and business functions. This model represents the ideal solution for meeting the needs of all clinical specialty practices and in fact is the approach we need to take as an industry for ultimately improving the overall quality of care.

One of the big problems to date with specialty EHRs has been that while many EHR providers boast about custom features for specialty practices, those claims turn out to be more about marketing than real substance. True customization for clinical practices requires a proper understanding of the needs and practices of each individual specialty and specific practice. It also requires months and years of diligent research and development to accurately meet the needs that have been identified.

Without proper adaptation, EHRs will not fit the needs of specialty physicians’ offices, and adoption will continue to be low. EHR providers should focus on ensuring that the common best practice functionality at the core of the EHR is solid, and then build on that foundation with well researched and developed functional modules that address the needs that are most important to specialty practices. A well-designed EHR is the most comprehensive and efficient means of capturing clinical data and is therefore the ideal tool to drive both clinical and business decisions for all kinds of specialties. Specialty physicians deserve to benefit from the hard learned lessons of the general medical EHR industry as well as features and functionality designed specifically for their practice and specialty’s needs.

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