Once you’ve narrowed your options, EHR selection comes down to how well each system supports your daily workflows. A feature list won’t show you how easily your team can complete tasks or where extra steps might slow them down.
Use these 10 questions during vendor demonstrations to see how each system you’re evaluating supports your team’s workflows, what switching will require, and what it may cost over time.
1. Can You Show Us How Our Team Would Complete a Typical Visit?
Ask each vendor to walk through a typical patient visit from start to finish. Use the same scenario for every demonstration so you can compare systems fairly.
Have the vendor show you how to:
- Schedule an appointment and verify insurance
- Complete patient intake and clinical documentation
- Place orders and collect a copay
- Send reminders and generate a claim
Next, ask the vendor to update a patient’s insurance information during the visit. Does the change appear in billing automatically, or does someone have to enter it again?
Ask the vendor to show how work moves between staff roles, how staff identify unfinished tasks, and where patient messages are handled. Watch how many screens staff members open and whether they enter the same information more than once. If the vendor skips a step, ask them to show it to you.
Look for workflows your team can complete without unnecessary steps and that work with your existing process.
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2. What Can We Customize Ourselves, and What Requires Your Help?
Your team shouldn’t have to contact the vendor or pay an added cost every time you need to update a chart template or change a setting.
Ask the vendor to show you how to:
- Add a field to a chart template
- Change appointment types or scheduling settings
- Update patient intake forms
- Change user permissions
Have the vendor make these changes during the demonstration so you can see how easily your staff members could do them. Pay attention to how the system handles custom EHR templates and whether changes require technical expertise.
Find out which changes require vendor support and how long they take. Ask about additional fees and whether the vendor trains your team to manage these settings.
Watch how the Azalea Health Ambulatory EHR lets you create and edit chart templates during implementation or at any time.
3. Can You Show Us What Happens When a Claim Needs Attention?
Don’t settle for a demonstration where every claim goes through without an issue.
Ask the vendor to show you what happens when a claim has missing information. Does the system flag it before submission?
Next, have the vendor open a denied claim and walk through the process of correcting it. Ask how a biller tracks a claim after resubmission and identifies any unresolved issues.
Assess how the vendor’s system lets your team:
- View the payer’s denial reason
- Access the related clinical documentation
- Assign the claim to a biller for follow-up
- Correct and resubmit the claim
With integrated EHR and billing, billers may be able to handle more of this work in one system. Ask the vendor to show exactly which steps require switching applications.
If you operate a rural health clinic (RHC), request an example using your billing requirements.
Count the manual steps. A process that looks simple during a demonstration may take longer when billers handle dozens — or hundreds — of claims each day.
4. Which of Our Required Connections Are Available Today?
Make a list of the outside systems your practice uses, including labs, pharmacies, imaging centers, and referral partners.
Ask the vendor to show a working connection with one of your actual partners. If you use Quest Diagnostics or Labcorp, request a demonstration of ordering tests and receiving results.
Use these questions to check each integration:
| Question | What to Look for |
| Does it work today? | An existing connection, not a planned feature |
| What information transfers? | Orders and results appearing in the correct records |
| What does setup involve? | Costs, timelines, and required testing |
| Who handles errors? | A clear process for resolving failed transmissions |
Ask about electronic prescribing and faxing connections as well.
A vendor may support common data-sharing standards without having a working connection to your partners. Confirm which integrations are ready to use and which require additional work or cost. Get a written confirmation of the vendor’s available connections, costs if any, implementation timelines, and which party does what.
5. Can You Produce a Report That Answers One of Our Actual Questions?
Instead of watching a demonstration of standard reports, give the vendor a question your practice needs answered to really see what the product can do.
For example: Which payers denied the most claim dollars over the past 90 days?
Have the vendor build the report during the demonstration. Watch how many steps it takes to filter results by payer and open an individual claim.
Try another question: Which providers have unsigned encounters?
A useful reporting system should help staff members find the records behind the numbers, not just display totals.
Check whether your team can create, edit, and export reports without vendor assistance. Also, find out whether the data updates in real time or on a schedule.
Finally, confirm which reports come standard and whether custom reporting or advanced healthcare analytics cost extra.
6. What Data Will Transfer, and How Will We Verify It?
Switching EHRs doesn’t always mean every record moves into the new system.
Get a written list of what the vendor will transfer to your new ambulatory EHR and what will stay in your old system. Check whether it includes:
- Patient demographics and appointment histories
- Insurance information
- Clinical notes and scanned documents
- Outstanding balances and accounts receivable
Some vendors transfer older notes as PDFs rather than searchable records. Others may leave billing balances in the previous system.
Find out how the vendor checks that information transferred is correct. Does it conduct a test migration before go-live? Who fixes missing records, and what will your team need to review?
Ask how your team will verify migration is complete and accurate before signing off for go-live. Confirm that staff can search historical records and use transferred information in daily workflows.
Get the migration scope and exclusions in writing, then check whether you’ll need continued access to your old EHR and whether that costs extra.
7. What Will Our Staff Members Need to Do Before, During, and After Go-Live?
Request a detailed implementation schedule, not just an estimated go-live date.
The schedule should show when your team needs to complete setup tasks, attend training, and test the new system.
Find out how many hours staff members will need for setup and training each week and who needs to participate. For example, if your five-provider clinic needs two front desk employees in training at the same time, can you maintain normal patient coverage?
Compare the proposed schedule with a typical EHR implementation checklist to understand the process and what your team will need to handle.
Ask who will help staff members during the first few days after go-live, and check what training is available when you hire new employees. Also find out how ongoing support works once implementation ends and how your team can escalate urgent issues.
If the schedule doesn’t identify responsibilities or time commitments, ask for more detail.
8. What Happens If the System Goes Down or There’s a Security Incident?
Check the vendor’s uptime history and ask what happens during an unexpected outage. Can staff members access patient records and continue charting?
Review the vendor’s recovery plan and focus on two measures:
- Recovery time objective (RTO): How quickly the vendor expects to restore service.
- Recovery point objective (RPO): How much recent data the system could lose during an outage.
Ask for the vendor’s SOC 2 Type II report, which includes an independent auditor’s assessment of controls over a specified period. Review the reporting period, which systems and controls were examined, and any issues the auditor identified. Also make sure the report covers the EHR you’re evaluating.
Find out how the vendor reports security incidents and how your team can contact support during an outage. Ask how outage notifications are handled and how work done during downtime is reconciled.
Choose a vendor that can demonstrate reliable uptime and strong security practices. And ask for written service and recovery commitments so you can compare them with the vendor’s uptime history and recovery plan.
9. Which Automation and AI Capabilities Can We Use Now?
Automation may save time, but ask the vendor to show you how its system automates everyday tasks and how staff can find and correct errors.
Start with insurance eligibility checks during registration. Have the vendor scan an insurance card and show where the information appears and how eligibility is checked. Can the front office correct an inaccurate policy number before saving the patient record?
For AI medical charting, have the vendor show you how the system creates a draft note and how providers review and edit it before signing it.
If the vendor offers automated payment posting, see how billers handle payments the system can’t match.
Confirm which features work today rather than appearing on the vendor’s roadmap. Check what setup or training your team will need, whether the tools cost extra, and how the vendor protects patient data.
If you’re just getting started with automated workflows or looking to expand what you’re automating today, read about healthcare workflow automation and how it can help reduce the burden on your staff and protect revenue.
10. Will the Vendor Put the Full Scope and Cost in Writing?
Ask each vendor for an itemized proposal that includes:
- Monthly software fees and optional features
- Data migration and integration costs
- Training, reporting, and support
- Transaction charges and renewal increases
Request a three-year cost estimate based on your expected number of providers and claim volume when applicable. Ask if the quoted fee includes unlimited claims, or if there are claim limits and overage charges.
Ask whether adding providers, opening another location, or adding more features will increase your monthly bill.
Ask how you can retrieve patient data if you switch systems later, including the export format and any associated fees.
Compare the proposal with what the vendor demonstrated. If a feature is essential to your practice, make sure the contract includes it.
Use Your Findings to Guide EHR Selection
Use the same questions and scenarios with every shortlisted vendor you talk to. That lets you compare systems equally. Review your notes or ask for a recorded copy of your demo so you can identify what each vendor shared, confirmed in writing, or left unresolved. Follow up on gaps before making your decision.
If you can, ask the vendor for references with similar staffing, specialties, and patient volumes and talk to them about the workflows that matter most to your team. Ask how the system performs during a busy clinic day and how responsive support is when problems arise.
Score each system against your priorities, giving must-have requirements more weight than optional capabilities. Discuss tradeoffs with your team, especially if a system falls short on a daily need.
The EHR Evaluation Checklist and Scorecard can help you keep everything organized. It includes eight checklists and a side-by-side vendor scorecard, so you can track what you’ve seen and assess how your options compare before choosing an EHR.
See How the Azalea EHR Compares
Get a walkthrough of the Azalea EHR and see how it stacks up to other EHRs available for your practice.
