EHR Adoption in LTC and the HIM Value. Appendix B: Vendor Questionnaire for EHR System Selection

Evaluation Criteria

Vendor A

Vendor B

Vendor C

Name and Address of Home Office
Phone Number
Sales/Contact Representative
Date of On-site Demonstration:


What is the cost (dollar amount) to purchase the system?
What is the cost of the annual support license fee?
What does this fee cover?
What are the training costs?
Are there travel expenses?
What is the cost (dollar amount) for technician service PRN?
What is the cost (dollar amount) for program/report development requested by facility?
Are there any additional fees?
What are the hardware requirements?

Background Information

In what states does the company have clients?
How many nursing homes use the system?
How many nursing homes purchased the system each year?
How long has the company been in business?
How long has the company been in the nursing home business?
Has the company ever been bought out?
Is the company debt free?
How did the company start out? What was its primary focus (i.e., pharmacy, hospital with LTC as side business, etc)?
How does the company make its money (i.e., sale of software, pharmacy business, resale of data back to facility, etc.)?
Is it proprietary?
How many staff members does the company employ (programming and support)?
Has the number of staff increased as more facilities are brought onto the system?

Start-up Support

What are the steps involved in launching the program?
Are on-site trainers provided?
What experience and type of support are provided in the start-up?

Continuing Support

What type of support is available on a 24-hour basis?
How is support provided (i.e., phone, online)?
What is the turnaround time for response?
What is the cost of support?
What does support cover?
What are the qualifications of the support personnel (i.e., programmers, nurses, CPAs, etc.)?
How is the software updated?
How frequently is the software updated?
What is the required downtime for software updates?
How are updates received and installed?
Are there opportunities for continued training? If so, how?

Program Information

Does the system operate on a Windows platform?
What is the programming language?
What type of database is utilized?
Does the system require additional proprietary software? If so, what is the cost and support for this software?
Does the company guarantee that its software will provide for a totally electronic (paperless) operation?
How long has this capability in software been available?
Does the system provide bar code input and read capability?
Is the system's touch-screen technology compatible?
Can information be entered from remote devices?

Interoperability and Standards

How has the company incorporated the HL7 LTC EHR-S Functional Profile standards?
What are the company's plans or roadmap to add EHR functions over time?
What are company's plans for CCHIT EHR product certification?
Are HL7 interfacing/messaging standards utilized?
Does the company allow information to be imported to a database? If so, how is this done and to which modules? (List the company's references of nursing homes that are currently utilizing this function.)
Does the company allow information to be exported? How is this done? (List examples of import/export functions currently up and running.)
Does this include capability to upload digital files and pictures? What format (PDF)?
Does this include capability to scan in reports? What format?
Does the clinical program interface with the financial program? How do the programs interface (i.e., demographic, clinical to bill, census)?
Will the clinical/financial program interface with the pharmacy company's software program? How? What is the cost?

Modules (Programs) Available

Clinical Module Components
Does the MDS input screen look like the MDS? Is it user friendly?
Is the care plan standardized or can it be individualized?
Does the system include daily charting of all disciplines?
Does the system include triggered charting?
Does the system include nursing assistant (ADL) charting?
Does the system include a pharmacy database? How does it interface with the EHR? How is this maintained and updated? How does it interface with the pharmacy?
Does the system include physician order entry system with alerts and warnings?
Does the system include safety features for med pass? Does it include audit functions and alerts for missed meds or required PRN med documentation?
How are meds passed/accounted for? Does the system offer key/touch or bar-coded entry?
Does the system include automatic stop orders?
Does the system include a documenting screen online and/or the ability to print MARs?
Are there any additional costs for CPOE and E-MAR?
Does the system include a rehabilitation module? Notes, schedule prompts and time tracker? How does this compare to a stand-alone rehabilitation software programs?
Does the system include a scheduling Program (for consults, labs, etc.)?
How easy is the system to use for coding? Does it print out in ICD language or can it be modified into normal medical terminology?
How and when are updates provided? Is the update adversely impacted by facility modifications to the medical terms?
Are there any additional costs for ICD updates?
Does the system include a quality assurance/assessment module?
Does the system include a financial program?
Does the system include an inventory program?
Does the system include a human resources program?
Does the system include a staff schedule program
Does the system offer education and CEU tracking capabilities?

Ease of Use

What do the documenting screens look like? Are they easy to maneuver?
What is the method of entry (mouse, keyboard, touch screen, voice, bar code)?
Does the system use programmed notes or narrative entries?
Does the system include an electronic co-signature capability?
Are data entered via electronic forms with drop-down boxes? Or selected from columns similar to a spreadsheet?
Is decision prompting available?
Are electronic alerts and counterindication notifications available? Are these pre-programmed, or can the facility add its own?
What is the average time required to teach the system to staff?
How would a facility handle charting from agency staff for the first time? How easy is the system to use for agency nurses who have had little to no exposure to the software?
Does the software program have a built-in report maker or does it export? How is this set up?
Can the facility develop its own reports, or is this assigned to a company technician?
Can the facility revise its own documenting screens, or is this assigned to a company technician?


Does the MDS input screen look like the MDS?
Does the system provide the ability to automatically scroll between sections of the MDS?
Does the system allow for the printing of historical MDS files?
Are errors triggered at data entry or at the end in an error report?
Can internal checks be added to the system, or is this pre-programmed?
Is there an MDS assessment scheduler? How does this work?
When opening a new MDS, do the previous scores pull forward or is the new assessment blank? Can the facility decide this factor? How do these features display? Can staff identify which are previous scores and which are current?
Does information from the care plan transfer into department-specific assessments?
Can the RUG score be checked at any time during entry?
Does the system indicate the best reference date based on supporting documentation?

Preadmission Questions

Does the system allow information to be input for a pre-admit prospective resident and then deleted from the system if not admitted?
Does the system allow the facility to custom design the entire pre-admission questionnaire online? How many fields?
Does the pre-admission module transfer information directly into the MDS as desired by the facility?


Does the program print the 802 rosters and 672 census reports? How are these reports updated? Can information be manually updated by staff?
Does the system have tickler file capability to handle outpatient and consultant schedules?
Can reports be customized based on all fields of the MDS, triggers, RAPS, RUGs, care plan, census, and assessments?
Can the facility design its own reports or must this be done by software programmers?


What are the security features of the system?
Does it provide security rights by password? Does it have a biometric capability?
Can the facility determine the parameters of password and changes?
What type of integrity audits are available? Can these be specified by the facility or are they pre-programmed?
What type of edit functions are available?
Can notes be appended without disturbing the date sequence (i.e., physician countersignatures)?
How is an entry error corrected?
How does the system accommodate surveyors during regulatory inspections where log-on and access to the EHR is requested?

Reference Checks

Will the company supply a complete list of facilities serviced?
List the name, address, phone number, and contact of the facilities contacted.

Back to Practice Brief

Article citation:
AHIMA. "EHR Adoption in LTC and the HIM Value. Appendix B: Vendor Questionnaire for EHR System Selection." Journal of AHIMA 82, no.1 (January 2011): expanded online version.