Choosing an EHR

 Key Takeaways

• Physicians must prioritize workflows over price, as cheaper ones can cost the practice in the long run.

• Choose an EHR that suits the practice size and specialty, avoiding complex on-premises EHRs.

• Understand the full cost of EHR implementation and communicate the concerns before signing the contract with the vendor.

Choosing an Electronic Health Record (EHR) for a small and independent practice is not only about picking the right Electronic Health Record features, but the real challenge is to undo the bad choice. Poor usability makes physicians replace their EHR systems soon. The replacement or discontinuation is not a minor tweak, but a complete reset.

Switching to a completely new EHR software is not cheap. Small practices have to spend thousands of dollars to get the data migrated. And the absence of a dedicated IT team and procurement department in small practices makes the replacement even more difficult. 

Due to the reasons mentioned above, modern medical practices should make informed decisions beforehand so they don’t regret their choice after signing the contract. Small practice owners make certain mistakes while choosing a reliable EHR software for their practices. This blog breaks down those early mistakes and the patterns that quietly lead to regret.

Mistakes Practices Make While Choosing an EHR

EHR failures do not happen after implementation. They start before the contract is even signed. Many practices choose an Electronic Health Record based on cheap subscription plans, surface-level features, and demos, which are not enough to reflect the credibility of the EHR vendor. 

Below are a few mistakes the physicians often make while choosing the right EHR for small practices. Learning about these mistakes beforehand can help physicians make smarter decisions for themselves.

Mistake 1# Choosing Price First, Workflow Second

Most of the time, physicians choose the EHRs based on the price plans. Healthcare providers are most likely to choose cheaper or free subscription plans. In the initial phase of implementation, the purchase might seem cost-saving, but later, the issues make the practice regret its choice.

A cheap Electronic Health Record system can also miss the non-negotiables for an EHR, like billing solutions, patient portals, interoperability, and security compliance. Later, the practice has to pay for these features separately, resulting in a higher amount than expected. 

Practice might get EHRs at the lowest prices, but the slow operational efficiency can cost them thousands of dollars later, with the lowest patient satisfaction. To avoid such a situation, modern practices consider the operational workflow of Electronic Health Record before the pricing options. Because if a better Electronic Health Record is reducing claim errors and denials, it means it is paying for itself. 

Mistake 2# Buying an EHR Built for Large Hospitals

Physicians who don’t understand the needs of their practice often end up buying the wrong Electronic Health Record for their practice. Oftentimes it is an on-premise EHR built for hospitals. Such EHRs are built for a large network of hospitals, with an extensive medical staff and IT teams. 

EHRs built for large networks have complex features and interfaces that require months to understand. A practice with three or more physicians does not need to integrate such an Electronic Health Record with a steep learning curve. 

A 2025 research published in npj Digital Medicine about a national survey of physicians revealed that physicians find it difficult to navigate through the complex interfaces, resulting in early physician burnout.

For small practices, a lightweight cloud-based EHR suits best. The prices can be higher, but it would be a one-time investment. A good and reliable Electronic Health Record can save a practice from spending thousands of dollars later. 

Mistake 3# Ignoring Total Cost of Ownership & Seeing Only the Sticker Price

Practices often choose an Electronic Health Record vendor based on the monthly prices shown during advertising. For instance, they choose an EHR with the cheapest subscription plans shown at the time of purchase, but later, the practices get charged for the extra unplanned expenditure.  

This shows that the price physicians see at the start is not the actual price. Electronic Health Record vendors charge extra for the implementation, staff training, and then for necessary solutions. Over time, these necessary add-ons cost the practice a lot later. 

2024 research on the perception of EHRs published in BMC Health Services Research also confirms that poor usability and poor design can increase time spent on documentation and other administrative workload. Such technical issues bring more indirect costs to the practice’s budget.

Mistake 4# Skipping the Specialty Fit Test

Some practices choose a general EHR system that usually does not fit their practice specialty (like dermatology, nephrology, cardiology, etc.). Every physician has different needs according to their specialty. For instance, a dermatologist needs an Electronic Health Record that can provide skin exam templates with procedure coding tools.

A general EHR may not have these specialty-specific features. Because of this, physicians often have to do extra work and create their own templates manually. Juggling between multiple screens and endless clicks makes the practice slow. 

Physicians can stay productive only if they integrate the right tools that reduce the workload. A 2024 research on EHR productivity published in the Journal of Graduate Medical Education also shows that optimized Electronic Health Record templates reduce the note-taking time by ~3.6 minutes per patient. 

This research also proves that choosing the right Electronic Health Record for specialty-specific clinics can make a huge difference.

Mistake 5# Forgetting to Ask What Happens When You Want to Leave

Practices sign long EHR contracts for 2 to 3 years without asking the vendors about what if they want to discontinue with the vendor or want to switch to some other Electronic Health Record. Because once the clinic data is stored in an EHR software, it may be under full control of the EHR vendor.

Vendors keep the data in a special format, usually in “vendor lock-in.” Research also shows that vendor lock-ins are major problems in healthcare because they sometimes limit a practice’s own access to the data. It also makes switching to a different Electronic Health Record system difficult and costly. 

To avoid such situations, healthcare providers should communicate their concerns before signing the contract. They must ask clear questions about data exportation, timeline, and the related costs.  

Choose the Right EHR for Small Practice

Choosing the right Electronic Health Record software has become a non-negotiable requirement for any small practice to thrive. Any wrong decision can undo all the progress the practice has made so far. That is why it is important for practices to avoid the mistakes most practice owners make while evaluating options for themselves.

Prioritizing workflow over price, selecting the right cloud-based EHR, and choosing what suits the practice best can save the practice’s time and money. A well-chosen Electronic Health Record should feel like an asset, not a burden!

FAQs

1. What are the common key challenges and issues with EHR?

The three key challenges with the Electronic Health Record system include a lack of interoperability, steep learning curves for staff, and complex interfaces with poor usability.

2. What is the most common mistake physicians make while choosing an EHR? 

The most common mistake physicians make is preferring the cost of the EHR first and workflow second. Healthcare providers often choose a cheaper plan with fewer features, and then pay for better solutions later.

3. Which type of error is most common in healthcare?

Medication errors are reported to be the most common in healthcare, occurring in 1-5% of almost all hospital admissions. This can take place during prescribing, monitoring, or even transcribing. 

This article was written for WHN by Dr. Muhammad Numan, who is a healthcare writer and Content Marketing Executive at Practice EHR, where he has spent the past two years creating impactful content for healthcare professionals. With a Master’s degree in Pharmacy, he brings a unique blend of clinical knowledge and marketing expertise to help health tech companies communicate more clearly and effectively. His work focuses on bridging the gap between complex healthcare concepts and accessible, audience-friendly messaging.

As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN neither agrees nor disagrees with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement.  

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