Practices usually start an EMR search by looking at systems. Demos are booked, feature lists are compared, prices are gathered. The question being answered is "which system is best", which has no answer, because the right system depends entirely on how your practice runs.

The step that gets skipped is writing down how it currently runs.

The exercise

On paper, in order, describe what happens from the moment a patient walks in to the moment the encounter is financially and clinically closed. Not how it should happen. How it does.

Include every step, including the ones nobody is proud of:

  • Who greets the patient and what they write down
  • Where the file is retrieved from and how long that takes
  • What is recorded in a book rather than a system
  • What is communicated by shouting across a corridor
  • What is tracked on somebody's phone
  • Where the patient waits and who tells them what
  • What the clinician writes and where it goes afterwards
  • How a test is ordered, how the sample gets to the lab, how the result comes back
  • Who works out what the patient owes, and how HMO cover is checked
  • What happens to the file at the end of the day

What this reveals

Three things, reliably.

Where the same information is written more than once. Almost every practice records a patient's name and details in three or four places. This is the clearest measure of what an EMR would actually save.

Where things go missing. The step where the process depends on one person remembering, or one piece of paper travelling, is the step that fails. Software helps here only if the new process removes the handoff rather than digitising it.

What is not a software problem. Some of what you find is staffing, layout, or an unwritten rule nobody has questioned. Buying software to fix those makes them worse, because now the broken process has a licence fee.

Then you can evaluate properly

With the map in hand, a demo becomes a specific conversation. Instead of watching a vendor show their strongest features, you walk them through your actual flow and ask how each step works in their system. The differences between products become visible immediately, and they are rarely the differences on the comparison sheet.

Decide what you are trying to fix

Write down, before you look at anything, the two or three problems the system must solve. Retrieval time for old records. Knowing what is owed. Stopping results going astray. If a system solves those, the rest is negotiable. If it does not, no amount of other features compensates.

This whole exercise takes an afternoon and it is the difference between buying a system and buying a system that gets used. Our EMR work starts here rather than with a demo, for exactly this reason.