Every electronic medical record (EMR) solution (also referred to as an electronic health record system) on the market is created differently. It’s impossible to build one with a one-size-fits-all mentality with such complex surgery center use cases, specialties, and reporting needs. ASCs commonly come across EHR and EMR solutions designed for hospitals or physician offices. Looking for an ambulatory EHR vendor can be like trying to fit a square peg in a round hole. It simply won’t work efficiently. ASCs need an ambulatory surgery center EMR that was designed specifically for them.

Here are some examples:

Physician: Allscripts, eCW, Nextgen, etc.

Hospital: EPIC, Cerner

ASC Specific: HST eChart, SIS

When evaluating ASC EMR software vendors, here is a checklist of questions to ask:

• Is it built specifically for the Ambulatory Surgery Center (ASC) market?
• Is it repurposed from different healthcare EMR users like a hospital?
• Does it contain all the necessary surgery center industry-specific and required reports?
• How often is the software updated?
• Does the software company have a client product council focused on surgery center EMR needs?
• Can I speak with current ASC customers?
• Is this the best ASC EMR software for my business?

Remember the Goldilocks Effect – you need to find an EHR that fits just right.

To make this a success, you must take the time to do a thorough analysis of how your ASC is operating today. By doing so, you’ll be able to identify holes in your processes and where there is room for improvement, helping build your case for moving forward with an ambulatory surgery center EHR. Without this foundation, it will be challenging to get your stakeholders on board with implementing an ambulatory care EHR software product and answer any questions that may come up. It will also be necessary as you build the case for executive or board-level approval.

Understand what is currently working or not working in your charting processes by asking the following:

• • Look at all areas of your internal processes – from scheduling to paper charting to payments.
  • What do the internal stakeholders like and dislike about paper charting? What do they like vs. what can be improved?
  • What do the external stakeholders like and dislike? Speak with your Physician’s Offices, Anesthesia Providers, Vendors, etc.
  • Gather all your ASC charts, begin an internal evaluation of the chart(s) and determine what changes are desired.
  • Look for areas of friction, when and where are you handling paper ASC charts?

Identify areas for opportunity and efficiency in your charting systems by asking:

• • • How does information currently flow into and out of the ambulatory surgery center?
    • What can you change?
    • What do you want to change?
    • What do you need to change?

Understand your ASC’s specific needs:

• • Perform a gap analysis of your ASC charting process.
  • Identify your programmatic processes.
  • Identify interface options and needs.

Identify the technology to support your needs including:

Hardware

• What currently exists? (laptops, workstations, tablets, etc.)
• What needs to be purchased?
• How many items need to be bought, and from where?
• Printers/Fax – what is compatible?
• Vital Monitors – what is compatible

Software

• What is included with the ASC EMR system?
• What is not included?
• How does this work with third-party software?
• Is third-party software necessary?
• Does it connect to towers, etc.?

Infrastructure

• What does your ASC need to build out?
• Evaluate wiring and wireless
• Look into your internet provider bandwidth and backup options.

By now, you have put a great deal of time and energy into preparing for the ambulatory surgery center EMR selection process – so let’s do it!

Steps to take once you are ready to start the selection process:

• Identify the best ASC EMR vendors you want to receive more information from.
• Consider creating a Request for Proposal (RFP) or questionnaire based on your desired echarting benefits.
• Put a timeline in place for selecting the best ASC EMR for your surgery center.
• Double-check on your ambulatory EHR market selection committee – who will participate in the selection process?
• Determine how many ambulatory EHR vendor demonstrations you need. Will they be in-person or online?
• Determine ASC electronic charting features that are critical vs. important vs. nice to have (no software is 100%)

Questions to ask during the demonstrations:

• Am I seeing the ambulatory surgery center EMR application in real-time, or is it a video?
• What features are working today vs. what is coming soon?
• How often do you perform updates?
• How often do you perform EMR software updates?
• Who are your partners?
• Who do you integrate with?
• Can you tell me about your security measures?
• Can I see your ambulatory EMR implementation process?
• Can I speak with other ASCs currently going through the implementation process?
• Do you offer custom reporting and state reporting? Can I add new reports?
• How customizable is the ASC EMR system?
• What does customer support look like?
• What is your average response time, and do you offer a ticketing system?
• Will I have a dedicated point of contact throughout implementation and post-go-live?
• What continuing education do you offer post-implementation?
• Walk me through the pricing – what exactly is included? Will there be any surprises?

This is where the “rubber meets the road.” The go live of an ASC EMR solution should be planned and carefully executed, never a guess! This is the culmination of the work and investment from your team. There should be a test of the asc electronic charting process followed by a soft go-live (a test run) and the actual go-live (fully turned on). Contingency plans should be in place; however, the team should be well trained and excited to move forward using the ASC EMR software.

Here are some items to confirm:

• Is there a soft go-live to test the environment?
• What are the resources available during go-live?
• Is there a contingency plan if there are issues during go-live?
• Are there means to stagger go-lives if we are launching multiple products?
• How long does post-go-live support last?

In conclusion, understanding the different ambulatory electronic health record solutions available today is crucial for ambulatory surgery centers looking to implement a system that fits their center’s needs. ASCs should avoid EHR solutions designed for hospitals or physician offices and instead opt for an ambulatory surgery center EMR designed specifically for them.

When evaluating ASC EMR software vendors, some tips to remember include:

• It’s important to ask questions about market specificity, user benefits, required CMS or state reports, software updates, client implementation, and ongoing support.
• Forming an internal committee with clear roles and responsibilities is essential to a successful EHR implementation plan.
• Conducting internal due diligence and establishing a baseline for current ASC operations and processes helps identify areas for improvement for your new EMR system.
• Seeking referrals and advice from peers who have implemented ambulatory EMR solutions can provide valuable insights and testimonials.

Selecting the right vendor requires careful consideration, including creating a timeline, forming a selection committee, and conducting demonstrations to assess critical features, security measures, support, and pricing. The ASC EMR implementation process should involve clear project plans, stakeholder involvement, data conversion discussions, and a well-executed go-live strategy. Ongoing education, training, and support from the ambulatory EHR vendor are essential for long-term success, including access to resources, feedback channels, and a collaborative partnership.