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Just as the right medical treatment is critical to a patient's health, the right approach to selecting and adopting an electronic health records system is critical to the health, and even survival, of a physician's practice. And it's not just about the technology.

Big problems can come from making the wrong EHR choice for the wrong reasons, and from expecting a software vendor to successfully implement an EHR system without the engagement of the practice's physicians. Those problems will cost much more than the federal stimulus funds being offered to encourage physicians to implement EHRs.

For physician practices, EHR selection and adoption isn't a spectator sport: Doctors must be actively engaged. They must focus on evaluating features that support patient quality, safety, outcomes, privacy, and security. But they also must insist on features that improve the efficiency and viability of their practices.

We've been working with the independent physicians in our area as they choose EHR systems. In order to be successful, physicians must keep in mind the following three ideas:

1. Deployment isn't the same as utilization. Technology makes it possible, but the art is in making EHRs personal to physicians and their staffs. One size doesn't fit all, so it's important to find a system that operates the way physicians in a practice think and work.

2. Functionality isn't the same as usability. It isn't about the number of bells and whistles an application has. Think in terms of number of screens and mouse clicks required to qualify not just for federal "meaningful use" requirements, but also to deliver "meaningful value" to you and your patients. Evaluate whether functions are supportive and not disruptive during clinical decision-making, patient care, and treatment.

We're hosting a "vendor click-off" event so physicians can make side-by-side comparisons of how many mouse clicks it takes to perform key meaningful use criteria. ONC-ATCB certification shows only that an application can perform the required criteria, not how easily.

3. "Data" isn't the same as "information." Evaluate not only how the EHR captures information about care provided during a patient's treatment, but also how seamlessly the information is available and actionable during subsequent visits. Evaluate if it can securely and effortlessly receive and exchange information across national, regional, and local health information exchanges, in support of collaboration with physicians and caregivers in other settings.