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Three questions asked of prospective electronic health records vendors can help an organization quickly determine which ones merit closer selection consideration in the meaningful use era, says Jeff Woodside, M.D., chief medical officer of The Breakaway Group, a Denver-based consulting firm.

He’s heard of delays for providers to actually get on waiting lists for EHR implementations, and other providers not getting needed help from vendors during and after implementation as vendor workloads start to increase. So, ask these questions, Woodside recommends:

* How much customization for workflow is available to individual customer sites?

* How much implementation and training does the vendor itself do?

* How rapidly can resources be made available when problems arise? Don’t just take the vendor’s answer at face value, Woodside advises. Talk to other customers of the vendor to see if they are prompt now or have been in the past, when vendors were less busy than they likely will be during the next couple of years.

A lot of vendor responsibility for helping their clients meet meaningful use requirements will be on making sure EHRs have the necessary capability to collect, organize and report data that measures compliance with specific criteria. That could be more challenging than envisioned, says Reid Conant, M.D., president of Conant and Associates, a Carlsbad, Calif.-based consultancy.

Typical canned reports in EHRs, for instance, will need to be refined or even redefined. For example, the criteria to provide a discharge summary upon release sounds reasonable and not all that difficult. Many EHRs can do this, but they can’t measure and report that the required percentage of patients got the discharge summary.

Another example: Where do you pull data to measure the treatment of a patient experiencing chest pain? Do you pull it from the triage note, the tracking board, the chief complaint, the discharge summary or from somewhere else? “Give vendors specific examples of your challenges, particularly reporting,” Conant advises. “Tools exist to comply with meaningful use, but not to report.”

Health care organizations that have been sitting on the fence waiting for the final meaningful use rules to come out likely will now move into concrete action, says Mitch Morris, M.D., national leader in the health information technology practice of New York-based Deloitte Consulting.

As they start, these organizations, he counsels, should look inward and ask themselves the following questions: What competencies do you have? What capacity do you have? What external resources will you need?

“A meaningful use road map should include not only goals and expected outcomes, but also timelines, staffing requirements and a projection of expected capital and operating costs,” Morris adds.