Cynthia Croy, MD, is the sole doctor at Family Health Center Direct in Joplin, Missouri, where she works with three support staffers. A year ago, the practice installed its fourth electronic health record (EHR) system.

Internist Albert Fuchs, MD, FACP, and his two physician colleagues switched from their old EHR to a new system a year ago to better serve their three Beverly Hills, California, offices.

Both Croy and Fuchs learned a few lessons while making the switch:

Don’t rush the selection process.

Croy said she rushed from her first EHR into her second one without putting enough effort into evaluating different systems. As a result, she ended up with an inadequate system. “It was not as advertised,” she said, noting that she junked it after a year. Croy said she now knows to take her time; she spent six weeks to eight weeks selecting her third and fourth EHRs so everyone in the practice had time to consider the functions most important to them and to vet several systems before making a selection.

Don’t ignore ancillary contracts.

Like many doctors, Croy automated telephone calls reminding patients about upcoming appointments. Her new EHR includes that function. However, her prior EHR did not, so she had a separate telephone appointment reminder system with different contractual obligations. Croy said she didn’t consider that soon enough in the switching process, so she didn’t cancel the contract before it automatically renewed. She had to buy out the contract, which cost her several thousand dollars. “Each ancillary vendor requires different things, so you need to look at each contract,” she said.

Don’t import too much old data.

Croy said in the past she imported PDFs of old records into her new EHR, a costly and tedious task. Plus, the PDFs were difficult to navigate and tended to have scrambled information and outdated data. Croy said she was more selective when she switched EHRs a year ago, instead importing only the data she deemed valuable. She started with patient names, birthdates, Social Security numbers and key test results. “The rest we put in as they came in, so we didn’t have a lot of bad data,” Croy said.

Don’t rubberstamp.

Fuchs said he knew it was unrealistic and prohibitively expensive to transfer all the data in his prior EHR to his new one. Still, the practice should have paid more attention to that process. He said the new vendor migrated three patient charts to show them how data would show up in the new EHR. “We thought it looked OK, so they did it to all of our patient charts. But when we started using it we realize that there were some downsides,” Fuchs said. Fuchs said if his practice had taken more than a few minutes when reviewing the test run, they could have saved themselves the “dozens of hours of wasted time” required to clean up the transferred data.

Don’t wait too long to switch.

Fuchs had his old EHR for about 12 years but said he wished he had switched earlier. “We’re kicking ourselves for acting like a captive without thinking about alternatives,” he said, adding that doctors “owe it to themselves to look at what else is out there every few years.”