Hi Rachal,
In the past I conducted analysis of several EMR systems to determine their fit with a specific target population (low income women of reproductive age).

Looking at EPIC, eClincalWorks, and NextGen, I found many differences that seemed to reflect their original intended use at time of development (e.g. internal med) and resulted in limited options (e.g. drop down boxes) that fit well for the intended patient population, but not so well when for different patient groups.

For example, documenting prenatal or postpartum care visits often did not naturally fit into the existing models. (My lens is from several years ago and may not reflect more recent changes). This was especially true when the care was more complex. 

Additionally, some EMR systems were more amenable to change. Adding screening questions to an existing EMR system is much different than integrating those same questions into the system in a way that maintains functionality.  Adding a checklist is less complicated, however a checklist that is fully integrated will offer far more uses, including pulling reporting data.

From a QA/QI perspective, a retrospective look at patient encounters can often highlight the training needs of staff/providers. So while it is far more complex and thus expensive, considering the longer-term needs of your patient population and health center a needs may be worth thinking about.

Please loop back around and share your learnings here! Together we can accelerate the ACEs science movement!

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Karen Clemmer (ACEs Connection Staff)