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Shopping for the right mental health EHR can be challenging for private practices. Software vendors package feature sets and services in different ways, making it difficult to compare one solution to another. The search for the right mental health EHR often results in going too big (paying for an overly robust package), going too small (foregoing or working around practice requirements), or entering the unpredictable territory of ordering features “a la carte”—in other words, when vendors allow individual features to be sold as add-ons to existing software packages, which further muddies the waters in evaluating the cost-to-value ratio of an EHR solution.

How to make sense of an apples-to-oranges comparison

Practices want to land on a solution that adequately covers their requirements and falls within budget, but the vetting process is difficult without asking the right questions. Understanding the best product fit begins with understanding the practice itself. EHR shoppers should consider the following:

1. How many EHR users do I have, and what kind of users are they?

Headcount is the most common pricing metric amongst EHR vendors. The number of providers will factor largely into what sort of quote the practice should expect to receive. Equally important is the type of provider. Psychiatrists and nurse practitioners should expect to incur larger costs than therapists, as they typically manage higher caseloads, have more complex workflows, and require more robust support. Be sure to ask about access for your biller and other administrative staff, though any fees incurred for non-revenue-generating staff should be low. Also, think about how the members of your practice collaborate, whether provider-to-provider or provider & staff, which leads into your next consideration.

2. What does my EHR solution need to address for my business?

The first question that drives the EHR shopping process is often, “what kind of features do I want?”, but it is important to think about EHR shopping in the business-to-business frame of mind. Private mental health practices fall into a trap of commoditizing EHR features when they need to be thinking about the problems they need to solve instead. This is a more meaningful approach to identifying product requirements, as opposed to going down a checklist of features.

Also consider what business needs the practice might have in the future. An EHR solution that can accommodate growth isn’t a bad idea, considering the inclination to grow over time that many practices demonstrate.

3. How much volume does my practice handle?

EHRs come in many flavors, and some are even structured around usage. Such pay-to-use subscription plans can sometimes be appealing for smaller practices that don’t anticipate heavy interaction and want to manage costs, but practices shouldn’t disregard the possibility of those circumstances changing if the practice experiences growth in the future—in which case the higher costs of being busier almost feel like punishment. Taking into account the volume of charts and notes will determine how much sense it makes to weigh a pay-to-use model against more common flat rates.

Handling claims via clearinghouses is another significant variable in the EHR purchasing process. Generally speaking, costs affiliated with clearinghouses are predictable, but EHR vendors handle contracts in different ways. Some, for example, have agreements with specific clearinghouses and have those costs linked onto their contracts with the practice. Other vendors leave the process entirely up to the practice, in which case practices would have to hunt down a clearinghouse on its own, sign a separate contract with it, and collaborate with all parties involved. This latter model typically results in lower EHR sticker prices and offers the practice the freedom to select its preferred clearinghouse, but practices will still need to account for the money and time spent outside the EHR contract itself in the grand scheme of things.

Understanding the value a vendor provides through its packaging is a matter of understanding the practice’s needs. Taking into consideration the practice’s typical throughput and how it plans on handling claims will give practice managers a better idea of what works best for them.

4. Additional considerations

What do startup fees cover? EHR vendors have different ways of parsing upfront costs, such as data migration, implementation, and training. Knowing what their startup fees cover will give the practice a better idea of what it might need to budget for further downstream.

Will I have to pay for supplemental services? Depending on the vendor, additional support and training might be billed separately. Practices that understand what kind of services they might need and whether or not they are covered under initial or recurring fees will have a much better idea of what to expect.

On the topic of budgeting, if you’re searching for an EHR to replace your current system, bear in mind that your current vendor may hit you with data extraction fees. Be sure to ask any current vendors about the format, timing, and price of getting your data returned to you. This is also a question worth asking any new EHR as you vet them.

While shopping for the right mental health EHR isn’t always an easy and seamless process, it doesn’t have to be a headache. Practices that ask the right questions when evaluating an EHR solution will find a more suitable fit, in spite of the sometimes confusing comparison between several competing software vendors.