EHR Software in 2023: Everything You Need To Know

What is EHR Software?

Electronic Health Record (EHR) software is a real-time patient-centered medical record. At its best, EHR software improves patient outcomes by increasing the efficiency and quality of healthcare delivery.

Healthcare providers use EHR software to store, organize, and share patient medical information and records with other providers and patients themselves. This offers some key benefits, such as:

  • Improve patient outcomes. Providers that can efficiently access and review patient medical history and treatment goals in the patient’s home can offer better patient outcomes.
  • Improve margins. Modern EHR software can automate key back office tasks, reducing costs as well as errors.
  • Improve clinician retention. Clinicians are less likely to burn out if they can spend less time managing patient records manually and more time helping patients.

EHR software typically includes a range of features, such as the ability to track medical history, record patient visits, complete clinical notes and orders, submit claims for payment, and generate financial reports at scale.

EHR vs. EMR Software

If you’re evaluating software solutions for your healthcare practice, you’re likely running into both EHR and EMR software. While there’s a lot of overlap between the two, and they’re often considered interchangeable, there are some key differences to take note of.


EHR systems are designed for interoperability and ease of patient data transfer. They can exchange and share data with other EHR systems used by other healthcare organizations. This is important if patients receive care across multiple specialists, hospitals, skilled nursing facilities, and home health agencies. The most farsighted companies take an API-first approach to their software development: Before writing a single line of code, developers, in partnership with the business, first design and build the Application Programming Interfaces (APIs) that enable the underlying app to connect with external applications.

Essentially, EHR systems make it easy for patient data to travel between providers and even different states. They also make it easier to provide records to Medicare, Medicaid, and commercial insurance payers. Providers get paid faster and spend less time tracking down records from multiple places. 

Interoperability is one of the most important features for EHR software, as the Centers for Medicare & Medicaid Services are promoting it as a means of more efficient data collection

By contrast, EMR systems tend to be designed for use within a single practice or provider. Most EMR systems are a digital replica of a paper chart—they’re meant to be used in a single practice for diagnosis and treatment. EMR systems typically don’t allow you to exchange data with other systems right out of the box.

Proactive Decision Making

A modern EHR system isn’t just a system of record. It should provide up-to-date intelligence and decision-making tools that enhance or automate key processes. 

An EHR solution should offer features like real-time productivity calculations for clinicians that power automated referral placements or dynamic compliance dashboards to ensure nothing is missing during intake and billing. Ultimately, it should help your clinicians and back office staff in the moment, not after the fact.

Modern User Experience

EMR systems often feel very dated and difficult to use for clinicians. They feel as though the software is working against them, making key processes more difficult. 

Modern EHR systems are built with user experience in mind, and make it easy to handle important processes while providing safeguards against inconsistent information.

Security and Privacy

Protecting patient data is extremely important. Legacy EMRs, while generally maintained, may not always integrate the latest data security practices. That makes more work for agencies to ensure their systems meet required security standards. 

Modern EHR systems, like Narrable, are integrated with modern security platforms such as Secureframe, which automates and ensures continuous compliance with key standards like HIPAA, SOC 2, ISO 27001, PCI DSS, CCPA, and more.

What Challenges Does EHR Software Solve?

Healthcare providers have significant challenges in managing and using patient data effectively. This extends not only to patient care, but the back office and business functions as well. Here are some of the biggest challenges healthcare providers are facing today, with a particular focus on home health agencies:

Missed Revenue Due to Payment Cuts

Processes facilitated by outdated EMR systems force providers to leave money on the table because they often fail to get the agency the correct amounts owed by insurance providers like Medicare and Medicaid. Given that Medicare proposes slashing payments year after year, providers can’t afford to lose payments due to poor processes.

The major culprits here are:

  • Failure to show progress against patient goals. Medicare payouts are based in part on agencies hitting patient goals. With outdated EMRs, clinicians often set goals and forget to track progress against them. This can lead to lower resulting payments from Medicare, negatively impacting revenues.
  • Failure to meet LUPA thresholds. Low Utilization Payment Adjustment (LUPA) thresholds are often a moving target for home health agencies. A single missed visit can cause agencies to lose out on thousands of dollars in revenue per period.
  • Failure to accept referrals before competitors. Competitive agencies utilize aggressive tactics, such as hiring 24/7 staff to continuously monitor incoming referrals. Home health agencies that are not quick enough to respond are losing patients and failing to meet census and revenue goals.

Higher Costs Due to Inefficient Back Offices

Without modern EHR software, many agencies have inefficient back offices. Some signs that your back office might be running at a less-than-optimal pace:

  • Manual insurance verification. Eligibility systems are often outdated, leaving back office employees to manually reverify patient insurance charges. During open enrollment periods, there are significant amounts of changes that have to be manually verified as well.
  • Disparate systems for authorization, claims, and remits. Home health agencies, like most other healthcare providers, have to deal with multiple contracts, billing types, and systems. Often, those systems simply can’t talk to each other, forcing agencies to enter the same data multiple times or in some cases even print and mail paper claims.
  • Paper-based compliance reporting. Compliance reporting often takes the form of multiple paper checklists. When it comes time for reporting, information is often missing or incomplete. Additionally, agencies often lack the bandwidth to adapt to ongoing regulatory and billing changes year over year.

Low Staff Retention

Without mobile-first, ergonomic EHR software, clinicians often recreate clinical documentation in paper cheat sheets, then manually re-enter them at home. Poor scheduling and inefficient routes leads to overscheduling and burnout. High staff turnover leads to coverage issues and places a higher burden on remaining staff.

How Modern EHR Software Benefits Healthcare Practices

More Top Line Growth

Not only is the CMS proposing further cuts to Medicare payouts in the next few years, existing payments may not even keep pace with inflation.

EHR software will be a critical tool for any healthcare agency in this macroeconomic environment by making it easier to:

  • Get actionable revenue insights that give you clear opportunities to increase revenue, such as real-time LUPA and PDGM case mix alerting.
  • Improve patient outcomes and OASIS-E scoring with a goals progress reminder that helps you prove good outcomes and prioritize lagging ones.
  • Accelerate new referral admission by using AI to monitor incoming referrals and automatically accept patients that match staff capacity.

Greater Bottom Line Efficiency

Of course, improving top line revenue is only one part of making your business more profitable. EHR software makes it possible to reduce costs borne from inefficient processes by:

  • Eliminating manual, redundant data entry by automating insurance verification and avoiding double entry for insurance and physician checks.
  • Consolidating systems so claims submission and remit posting are done automatically, rather than via manual processes in disparate systems.
  • Simplifying compliance reporting to ensure compliance information is always complete and preventing errors from having multiple checklists.

Improved Staff Retention

Staff burnout is common in the healthcare industry as a whole, and home health agencies are especially susceptible. Data shows that 21% of home health agencies said that poor work-life balance caused turnover. In 2022 alone, the turnover rate for LPNs was 30.25% and 31.19% for RNs.

Poor work-life balance for staff often takes the form of working on documentation after hours, during personal time. Overscheduling and overtime is rampant due to manual/spreadsheet-based scheduling, and extended drive time due to poor route planning leaves clinicians burnt out.

EHR software streamlines most of the arduous manual tasks involved with documentation and scheduling by:

  • Making it easy to complete clinical notes on-site instead of leaving work for personal time.
  • Automatically recommending clinicians based on capacity to prevent overscheduling and burnout.
  • Automatically recommending clinicians based on their distance to the patient to reduce unnecessary driving.

Finding The Best EHR Software For Your Home Health Agency

There’s no shortage of options for EHR software, which can make finding the right solution for your agency difficult. In this section, we’ll help you understand the key things to look for as you evaluate your options for an EHR system.

Look for API-First EHR Software

The most crucial criterion you should have for EHR software is that it should be built as an open API platform that enables interoperability and meets the standards for a Certified EHR as laid out by the CMS. 

Many legacy EHR vendors do not meet this standard, which means you’ll either fail to meet the CMS’s definition of “Certified EHR,” or you’ll have to find ways to customize your legacy solution for greater interoperability. These custom solutions are often brittle and costly.

Modern EHR systems, such as Narrable, are API-first, so integration and interoperability are built into the software out of the box. Interoperability is key because data needs to be structured and standardized before you can reap the benefits of automation. 

That’s critical for getting the ROI you need from EHR software. Our estimates show that automation alone can save a home health agency over $200,000/year from improved productivity.

Modern EHR Software Features for Your Entire Business

Modern EHR software shouldn’t only benefit one part of your practice. The solution you choose should bring all areas of your business together, improve communication and data flows, and make everyone’s job more efficient. 

Here is a department-by-department breakdown of the key features you should look for in modern EHR software:

For Owners/Executives

Executives need ways to quickly identify opportunities for growth, keep tabs on cash flow, and provide clear on-demand reporting. Here’s what to look for:

  • Growth reporting that drives admits and breaks down patient census by revenue factors.
  • Financial and Revenue reporting that gives accurate, real-time views of critical metrics like cash flow and annual revenue.
  • Compliance reporting that ensures compliance against the home health conditions of participation.

For Directors of Operations

Back offices and operations can benefit greatly from automation. EHR software can automate most key processes, reducing errors across key processes. Look for:

  • Referrals management that automates acceptance so you can admit patients faster.
  • Staffing and scheduling modules that automatically recommend patients to staff based on distance and clinician capacity.
  • Calendar integrations to ensure clinicians have offline-friendly versions of their appointments and reduce missed visits.

For Directors of Nursing

Clinicians are on the front lines for home health agencies, but they’re often bogged down in manual paperwork, leading to burnout. Here’s how modern EHR software can give them hours back to focus more on helping their patients:

  • Clinical documentation designed with ergonomics in mind, flowing with the clinician as they move through the patient’s home—no more working on piles of paperwork in the evenings or taking focus away from the patient and family during the visit.
  • Plan of care carryover from note to note so clinicians are always reminded to focus on the goals and treatments that lead to improved outcomes.
  • Real-time OASIS-E quality checks that enable quality documentation upfront, not after QA review.

For Directors of Finance

Billers are responsible for ensuring your agency is paid for your services, but are expected to juggle payer differences, multiple portals, and an ever-changing landscape all at the same time. Look for integrated Revenue Cycle Management including:

  • Payer rules that capture the differences between payers while simplifying the payer setup process.
  • Claims that are automatically generated, coded, and submitted in real-time.
  • Remits that are posted automatically against your claim with translated adjustment reasons.

The world of home health is changing rapidly, and the solutions agencies use to meet new challenges have to evolve as well.

Looking to upgrade your EHR software? Book a personalized demo with our team today and we’ll show you how you can use Narrable to drive revenue growth, increase margins, and bring confidence to your clinicians.

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