Serving the home health, home care and hospice industry since 1999.

by Darcey Trescone, RN, BSN

No software fits right out of the box. If it did, we would be purchasing our EMR software off the shelf at Best Buy. It is the purchaser's responsibility to ensure their chosen software will flow well within their agency, their vendor's offered services are defined, and that any identified gaps in functionality are adequately spelled out contractually before signing.

This responsibility begins right at the time of software selection. As you assemble your team and prepare for software demonstrations it is important to outline the following:

  1. Why are you looking for a new system?
  2. What functionality do you have now that you like?
  3. What functionality do you not have and need?
  4. What are the key traits you are looking for in a vendor?
  5. What ancillary systems do you presently have in place that will require an interface (telehealth, payroll and financial for example)

Everyone on your software selection team should understand your needs as outlined above. Your team should contain your subject matter experts from sales, referral management, scheduling, timekeeping/payroll, clinical care team, clinical compliance/oversight, billing/financial and leadership. The subject matter experts in each area should have a working knowledge of your current processes, struggles and reporting needs in their respective areas.

Software demonstrations can be at a high level initially. This allows your software selection team to narrow down the list of EMR systems for consideration to two to three. Once you have decided on your top EMR candidates you will want to do more in depth demonstrations to ensure you learn as much as possible about their systems.

It is important during subsequent software demonstrations with your top candidates that your software selection team does the following:

  • Walk thru your processes while reviewing the system
  • Identify aspects of the system that will enhance your agency
  • Identify internal processes you will need to change if you were to purchase
  • Identify product functionality gaps that you will need resolved
  • What ancillary products will you need to purchase or change (report writers, dashboards, telehealth, payroll and financial for example)
  • What ancillary products do you presently have that will require an interface to the new system (does the vendor have these interfaces in place, will they require modification to meet your needs 'or' do the interfaces need to be built)

Document your findings after each demonstration. These findings will assist in your follow up demonstrations and discussions with the vendor prior to selecting a vendor of choice.  Your subject matter experts in clinical care, clinical compliance/oversight, payroll and billing will require time with the vendor’s subject matter experts to ensure these areas have been adequately covered and there are no surprises.

Prior to moving into any contractual commitments with a vendor it is important to understand:

  • implementation services specific to your agency and the size of your team
  • support services available and any service level agreements the vendor provides
  • vendor hosted services and any guarantees they offer around limiting the % of system downtime
  • cadence of system updates/changes and history of meeting regulatory changes in a timely manner

Contractually the agreement should demonstrate your understanding of the above listed items. In addition, the contract should be clear around the following:

  • core system functionality and any additional modules/functionality that you need and is presently available from the vendor
  • product functionality gaps that will be resolved and by what date
  • interfaces you require to any ancillary systems as discussed previously
  • any ancillary systems/tools that you are getting from the vendor or are required to purchase prior to implementation

The software contract is the vendor's commitment to you that they are delivering on what was discussed and your commitment to the vendor that you will maintain and utilize their system as provided. The contract should provide your agency with warranties and guarantees that what is purchased is delivered. If the vendor is in breach of these warranties and guarantees your agency should be able to cancel the contract but it's critical that the contractual verbiage supports this, outlines what exactly you need to do and provides you access to your data in a usable format.

Darcey Trescone is a Healthcare IS and Business Development Consultant in the Post-Acute Healthcare Market with a strong background working with both providers and vendors specific to Home Care and Hospice. She has worked as a home health nurse and held senior operational, product management and business development positions with various post-acute software firms, where her responsibilities included new and existing market penetration, customer retention and oversight of teams across the U.S., Canada and Australia. She can be reached at


©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.