Team EHR: Support (will your dental software vendor walk the walk?)

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By Mike Uretz
July 25, 2013

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Editor's Note: This is the sixth installment in the series on electronic dental records with expert Mike Uretz, editor-in-chief of See the previous article here.

For some reason, Murphy’s Law seems to come to the fore once a system is installed, the final payment tendered, and the practice dependent on the technology. I wish I had a nickel for each story I’ve heard of vendors that closed the deal and then “just didn’t show up” when the customer had problems or issues.

Ever heard of the term “turnkey system?” The generally inaccurate assumption regarding turnkey systems is that they’re installed, the “key is turned,” it works, and all will be fine. Wrong. There is no such thing as a system that doesn’t need a solid plan for maintenance, support, and upgrades and enhancement. And this is where many contracts fall short – they don’t take into account the problems that occur after implementation in enough detail.


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If you do run into problems, how long will the vendor have to address these problems – immediately, or in two to three days? What are the penalties if the vendor doesn’t meet stated commitments? Sales people will commit to taking care of you, but unless there are real consequences for the vendor, you might not be the “squeaky wheel” you thought you’d be.

During the sales process, sales people are quick to assure you of great support, but can your vendor “walk the walk” as well as “talk the talk” once the system is in place?

How to avoid support problems
To address support concerns, the Service Level Agreement (SLA), is the standard mechanism to document vendor commitments. These agreements outline various areas of accountability in which the vendor is willing to make a commitment to service and support. After all, you’re paying a percentage of the license fee on an ongoing basis for your support, so you have the right to demand good service.

There are numerous items to think about when putting together a service agreement. Some of the main areas you will want to address include:

  • Hours of support
    Don’t accept such terms as “support during standard business hours.” What if your vendor is based on the east coast? Standard business hours for your vendor might be 8 a.m. to 5 p.m. Eastern, but if you’re located on the west coast, this means you can’t get support after 2 p.m. your time. Instead, have your contract specify “local time.” You’ll also want to specify how support works during off-hours and whether the vendor will charge you an off-hours fee with proper notification.
  • Problem escalation and triage
    Whether it’s your cell service provider or your bank, you’ve probably become frustrated by the lack of knowledge or problem resolution by the immediate support person and have had to ask to “speak to the manager.” The same holds true for your EHR vendor. It pays to ensure that the levels of escalation are specified ahead of time. This can include having the vendor’s support person actually come on site if the issue can’t be resolved by other means.
  • Response time guarantees
    These need to be clarified in your contract as well. If response time is an issue that affects patient care, you need to know if you’ll be expected to wait two days or if you will receive help immediately. Be aware that different functions of the EHR system might warrant different response times. For example, charting problems or bugs might need immediate attention, while a problem with a patient education component might not be as urgent. Your contract should spell out response guarantees along with associated penalties. Don’t accept a vendor telling you that they have a history of great service. Get in it writing. Be the “squeaky wheel.”
  • Introduction of new updates or versions
    What about changes, updates or improvements to your licensed software as time goes on? I’ve seen contract clauses where vendors have the right to reduce or even drop support for a system at some point in time if you haven’t upgraded to the newest version. You should always expect that a vendor will support the current version and the previous version of your system. You might not want to install the newest version right away, as the time to test and install a new version is not trivial and can possibly impact your internal resources and the operation of your practice. Also, in terms of always upgrading to the newest version, make sure the additional features add value to your practice needs and warrant an upgrade. Sometimes, the old saying “If it ain’t broke…” has validity.

Accountability is Key
Don’t let your dental software vendor get away with mere promises of great support. Make sure it happens. The key is accountability. Your vendor will have numerous customers that are all competing for the ear of the support staff should problems occur. The question is how do you assure that you will be the squeaky wheel in this scenario? With a support agreement laid out in black and white – in writing – of how your vendor takes care of you. Your vendor might have good intentions, but different situations can come up in which a vendor support staff has to prioritize based on their resources – and you want to make sure that you are one of those priorities.

Uretz BorderMike Uretz is a 30-year software veteran and nationally-recognized Healthcare software and Electronic Health Records (EHR) and expert. Mike has consulted with hundreds of practices and multi-clinic groups to help them properly evaluate and select their software solutions, structure and negotiate contracts, and provide management and oversight for their implementations. As co-chairman of the Best Practices advisory committee for EHR Contracts, Mike was instrumental in developing standards for structuring software contracts and pricing used nationwide. Mike is the founder and editorial director of, a trusted and objective online resource on all matters related to dental software. Mike is also the founder of the LinkedIn group Dental Software, Electronic Health Records and Electronic Dental Records. Mike can be contacted at
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