EMR: When it’s time to make a choice

Avoid a bad fit by identifying the “right” EMR system based your practice’s unique needs.

Choosing an electronic medical records (EMR) system can feel like a daunting process. With all of the choices in the marketplace, the last thing a practice needs is to invest the time, effort, and cost of implementing an EMR system that turns out to be the wrong fit. Thankfully, practices can avoid this outcome by taking the necessary steps to find the “right” system. Here, doctors and staff discuss their process of identifying the EMR systems that matched their practices’ unique needs.

Gaining efficiency

Sheena Lee, COA, OSC, of Eye Centers of Tennessee (ECOTN), says the practice’s former EMR felt like it hampered efficiency. Other than finding charts quickly, the EMR “slowed everything down” at the four-location practice.

“It was actually faster to just revert back to paper than to use the system,” Ms. Lee recalls.

When ECOTN began the search for a new EMR, the staff’s previous experiences allowed them to develop a clear list of “what works — and what doesn’t.”

“Ease of use was important to us,” says Ms. Lee, who adds that the practice eventually chose Nextech’s EMR.

“After an experience where we felt like too much clicking through pages slowed us down, we were looking for something that would be more efficient,” she continues. By attending webinars offered by EMR vendors, “we could get a sense of which systems seemed easier to use.”

Handling multiple operations

In addition to efficiency, many practices also want a robust system that can handle multiple operations within the practice, which can be a challenge. For example, “The need for a system that could smoothly manage optical inventory as well as it managed the overall practice — everything from patient data to billing and insurance — really limited our options,” says Eric Quartetti, MD, of Fox Valley Ophthalmology, which has two locations in Illinois. “We found very few that did all of those capabilities well.”

The practice ultimately went with Ophthalmology Advantage from Compulink, which Dr. Quartetti says offered the “all-in-one” solution they were seeking. It has also been “adaptable,” which is another key “feature to look for,” according to Dr. Quartetti.

“Doctors are very individual in the way they do things. We have three optometrists and four MDs and each does things differently. It was key that we found a system that was adaptable to the way each of us works.”

Involving the team

In terms of personnel who participated in the research process, Tammy Griffin, administrator for VisionFirst Eye Center, a practice with four Alabama locations, says that there’s no question that you need “buy-in from the doctors,” as they’ll be using the system often. But, Ms. Griffin says it’s a common misconception that only the doctors and the technicians will be using the EMR.

“For us, optical, billing, and the front desk are all regularly using the system, too,” she says. “Even if they’re not involved in the research, they need to be very involved in the training.”

Ms. Griffin and the practice’s finance officer were the two key people conducting the research. Once they narrowed the search down to a few key systems, then they involved the doctors.

“My best advice is to involve your staff in the process,” says Ms. Griffin, who adds that they ultimately chose Eye Care Leaders’ cloud-based EMR system. “Ask them to walk you through their day and pay attention to the ways in which they’ll be using the system. Use that information in your search process. It will make the transition easier.”

Tracking a mobile solution

For Erik Niemi, DO, an ophthalmologist with Advanced Eyecare, with two locations in Vermont and a location in Massachusetts, it was the mobile capabilities and user experience that led the practice to Modernizing Medicine’s EMR, EMA, in the modmed Ophthalmology suite. He says it has allowed the doctors and technicians to take an iPad from room-to-room to document patient cases. Ultimately, he viewed that as a savings since the practice did not have to buy PCs for each lane.

Dr. Niemi adds that once a practice has narrowed their choices down to one or two systems, they must speak with a couple of practices who have already been using them.

Better yet, do a site visit as VisionFirst Eye Center did. “We looked at many, narrowed it down to two, and then did site visits,” Ms. Griffin says. “That helped us make our final decision.”

EMR vendors

The following is a sampling of EMR companies that serve ophthalmology. This listing will be routinely updated on the online version of this article at



EyeCare Leaders




iMedicWare (EyeCare Leaders)

Integrity EMR for Eyes (EyeCare Leaders)

IO Practiceware (EyeCare Leaders)

KeyChart Key Medical Software Eyecare Leaders

ManagementPlus (EyeCare Leaders)

MaximEyes by First Insight

MD Logic

MDoffice (EyeCare Leaders)

MDIntelleSys (Nextech)



Medflow (EyeCare Leaders)

MedFormix Crowell Systems

Medical Mastermind


Meditab IMS


Modernizing Medicine

My Vision Express





Practice Fusion

Practice Partner

Prime Clinical Systems

Quickview EMR




Waiting Room Solutions

The benefits of adoption

Dr. Niemi says there is a fear that an EMR will make the practice slower, but that hasn’t been the case for him. And the new system has enabled him — and the practice’s other doctors — to document better. In turn, that has allowed him to code appropriately, which has been incredibly valuable.

“With paper documentation, we were always under-coding as we failed to fill everything out to meet the criteria for something like a 99214 code,” Dr. Niemi says. “We were probably billing a level three and level four. Now we can actually code to the level of work we’re doing.”

The EMR can make claims submissions less burdensome. For example, the system’s user-friendly drawing tool makes it easier for billing and coding of extended ophthalmoscopy, which requires a detailed drawing of the retina as part of the medical record.

All of those interviewed noted the benefit of finding patient charts more easily, which proved particularly beneficial for practices with multiple offices.

“From an office management point of view, many hours have been spent pulling charts and putting charts away,” says Dr. Niemi. “An EMR has reduced our need for staff that only perform chart pulling and organization — and that’s a big overhead cost.”

Prior to using the EMR system, Dr. Quartetti says that a staff member transported paper charts in a bin in their car. While no breach of patient information ever occurred, Dr. Quartetti says he was happy to see that risk go away. He has also appreciated the ability to pull up patient information while on-call if he needs to consult with a patient during an emergency. He says he’s able to provide better care as a result.

And, he no longer has to decipher handwriting from another physician’s note in the chart. “Someone jots a quick note and it may not be as easily read by another person — that’s eliminated with an EMR,” Dr. Quartetti says.

Getting the hang of it

While the process of selecting an EMR system may appear daunting, practices should not be discouraged from taking the time to select a system that will ultimately meet their needs.

“Everything from the research to the actual implementation can feel overwhelming at times,” admits VisionFirst’s Ms. Griffin. “But, by three months’ out from going live, we had all really gotten the hang of it. By six months, the majority of our staff said they could never imagine going back to paper charts. The days of missing charts are over for us, and we don’t want to return.” OP