Apr 22 , 2014

TIPs for Choosing a Customizable EMR to fit your Practice


When choosing an EMR, it’s important that the software is well organized and fits into your existing workflow. An EMR is not a one-size-fits-all solution, and while the software may work on a basic level out of the box, the cost of an EMR that doesn’t suit your needs are high. An ill-suited EMR can lead to pushback from staff, loss of efficiency, reduced productivity, and disruption of revenue.

The needs and workflow of medical professionals can vary widely even within the same medical field. The best option is an EMR that is delivered with customizable templates which are existing “draft” forms and workflows that are built to the needs of your medical field.  Typically the templates are not meant to be used as-is, but to be validated and finalized per the specific needs of your practice.


Many practices rely on someone in their practice to build or customize the forms and workflows based on the templates delivered with the system. This is generally a good idea if your practice has software savvy resources or access to a dedicated and experienced IT staff. The skill set, time and human resources needed to build effective forms and workflows may be present in your practice but these resources should also understand how the EMR will be used. Personnel who do not interact with or have hands-on experience in certain parts of running the practice may not understand the needs of other users. For example, an office manager may not know the selections physicians and their aids make on every visit. If your practice has more than one specialty, physicians versed in one specialty may not be familiar with the requirements of the other.

Ensuring that the EMR you choose has strong customization tools that do not require specialized technical skills and draft templates will help your practice have a successful implementation.  Your EMR should make it easy for custom-built forms and workflows to be maintained by your staff, which reduces your dependency on the EMR vendor. Customizable forms and workflows are one of the most important aspects of an EMR.  Maintain good documentation for later reference and depending on your selected EMR can prevent headaches and frustration when the software is upgraded.  Better is if you can choose an EMR that does not have dependencies where a software upgrade may impact a customized form. Be sure to inquire on this important question during your evaluation.


The first step to proper customization is to determine which diagnoses your practice makes most frequently. Ideally, you should perform this step before choosing an EMR vendor to ensure the software has the capability to do what you want.

Have your practice manager generate an ICD-9 frequency report. You can use the report to determine which selections you will need to prioritize. This will ensure all the options are easily available and the provider will not have to waste valuable time hunting around for the correct selection.

While forms and workflows allow for timesaving features some shortcuts can encourage risky record-keeping habits. EMRs can pull notes from previous visits and place them into the form automatically. This can cause problems if the notes are not reviewed during each visit. After repeated visits, the generated encounter forms could contain a long list of information that is not reader-friendly and takes more time to review. The notes may have data that no longer applies to the patient and could leave the practice at risk in an audit is performed.

Ideally, an EMR charting system should read similar to a handwritten note. Only the most relevant information should be displayed by default, with background data readily available within a click or two.


EMR customization is the primary means to successful EMR usage. When the EMR is customized to fit your particular field and practice, you can maximize your return on investment and minimize the risk to patients and your bottom line.  Here is a set of customization questions to add to your EMR evaluation list.

1.     What can be customized?

2.     Who does the customization?

3.     How long does it take?

4.     What does it cost?

5.     What happens when the software is upgraded?

6.     Can I continue to run my practice as I do today?


ZH Healthcare has worked with numerous types of practices and specialties and has built a large library of forms and templates.  The ZH OpenEMR cloud-based solution has robust customization features that allow your staff to customize the EMR and make it unique to your practice. Using the ZH OpenEMR Screen Flow Customizer your practice can decompose existing forms into form components or building blocks.  These can be reassembled into combination forms that provide multiple methods of building encounter notes including prompt and replace, database integration, hand written notes, dictation, checkboxes, selection boxes, lists, and other time saving charting features.  Our Go-Live Services teach your staff members how to create and customize your forms to meet your needs.  Knowledge of the practice’s workflow and needs is the primary skillset required.