How to shortlist EHR vendors based on your requirements

Selection teams who are considering a prospective pool of EHR vendor-candidates to engage should, ideally, carry out their selection process based on an inverted pyramid approach. The inverted pyramid metaphor represents how general information (the broad base of the pyramid) is processed and narrowed down to an ultimate decision regarding which product best serves an organization’s requirements and goals. The shortlisting process falls on the narrow peak of the metaphorical inverted triangle whereby the selection team is now conducting a deeper dive into how prospective candidates align with a practice’s EHR strategy and requirements.

Shortlisting EHR vendors

The process that is used to arrive at a shortlist of candidates, just as is the case for the overall selection process, must be based on sound selection criteria that are tied to a practice’s EHR requirements and goals. A sound selection criterion is not only goal and requirements oriented - it also must be methodologically sound. What this means is that, in theory, an outside observer should be able to understand the methods that underlie the decision and ultimately understand how a decision was arrived at.

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The shortlisting process, if conducted properly, should result in a list of products that are the most closely aligned with an organization’s EHR requirements when compared to other candidates.

Prioritizing EHR requirements

Prioritizing EHR requirements refers to the ranking of requirements based on need with the understanding that not all requirements may be met by a product. Therefore a prioritized list of features can be used based on the features scorecard completed by stakeholders during the selection process.

The features scorecard should allow stakeholders to assign a numerical value to each function or usability characteristic on a scale of 1 to 5 - with 1 representing the lowest priority and 5 representing the highest priority. Stakeholders would then score an EHR’s performance on a number of characteristics on a scale of 1 to 5 - with 1 representing poor performance and 5 representing excellent performance. With this data, a practice can weight performance according to priority and then gauge performance appropriately. The American Medical Association Digital Health Implementation Playbook suggests evaluating vendors across six areas: business, information technology, security, usability, customer service, and clinical validation. Based on the scoring of these requirements, a selection team can prioritize which requirements are essential to an organization's goals and which requirements can be viewed as discretionary.

What the shortlist should contain

A shortlist should, at a minimum, contain a list of products that first meet prioritized requirements with additional consideration given to candidates that can fulfill the discretionary requirements as well.  To answer this question the selection team would examine whether a vendor's product offers prioritized requirements in its core package. If not, selection teams should consider if the vendor meets these requirements beyond its core offering or is it included in additional software modules or through optional add-on services.   

Arriving at the required information needed to construct an EHR vendor shortlist should consider information gathered previously in the selection process, but also, information from other organizations who may have used the product and can offer first-hand experience on the functionality of certain features.