I've sat through HMS demos on both sides of the table — as the person giving them and as the person evaluating software for hospitals I've worked with. The experience is remarkably similar every time. The vendor shows a polished demo with perfect data. Everything looks great. You sign up. Three weeks in, you discover that the feature you assumed worked a certain way actually doesn't, and now you're stuck.
The problem isn't dishonest vendors (most aren't). It's that demos are designed to show strengths, and buyers don't know which questions to ask to find the weaknesses.
Here's the checklist I wish someone had given me. Not a feature comparison — a set of questions to ask and things to test before you commit.
This is the single most important module. If OPD is slow, nothing else matters — your doctors won't use the system.
- Time the prescription workflow. Sit with a doctor and have them write a real prescription. Not a demo prescription. A real one for a patient with diabetes and hypertension who's on five medications and needs a follow-up. If it takes more than 90 seconds, ask why.
- Can the doctor build custom templates? Not the vendor's templates — the doctor's own. Every doctor has their go-to prescriptions. The system should let them save and reuse these.
- How does it handle follow-ups? When a returning patient walks in, how many clicks to pull up their history and start a new visit? It should be one or two, not five.
- Does it support specialty-specific findings? An ophthalmologist's clinical findings look nothing like a cardiologist's. Does the system have structured forms for your specialty, or is it just a free-text box?
If you admit patients — even occasionally — this matters.
- Walk through an actual admission-to-discharge flow. From the moment a patient is admitted to the final bill at discharge. How many steps? How many different screens? Where does information get entered twice?
- How are bed charges calculated? Automatically based on admission time, or manually entered? Does it handle bed transfers mid-stay?
- How do nursing notes work? Can nurses enter vitals and observations from a tablet at the bedside, or do they need to go to a desktop station?
- Discharge summary generation. How long does it take? Does the system pull in data from the stay automatically (vitals, procedures, medications), or does the doctor write it from memory?
Billing is where most HMS implementations reveal their cracks.
- Ask about TPA and insurance billing. If you handle cashless patients, this is critical. Can the system generate TPA-specific bill formats? Does it track pre-authorisation? Can it calculate patient share vs. insurance share automatically?
- Government schemes. Ayushman Bharat, state health schemes — does the system support them? What about the specific claim formats these schemes require?
- Split billing. A patient who's partly insured, partly cash, with a corporate discount on room charges. Can the system handle this without the billing clerk doing mental math?
- Receipt and invoice formats. Can you customise the bill format with your hospital's logo and layout? This sounds trivial but matters to patients and insurance companies.
- Is pharmacy integrated with prescriptions? When a doctor writes a prescription in OPD, does it flow automatically to the pharmacy counter? Or does the pharmacist retype it?
- Stock management. Does it track batch numbers and expiry dates? Can it generate purchase orders when stock runs low?
- Drug interaction alerts. When a doctor prescribes two medications that interact badly, does the system warn them? This is a patient safety issue, not a nice-to-have.
- Order flow. When a doctor orders a blood test, does the lab see it automatically? Or does someone carry a paper slip?
- Result entry and reporting. Can the lab technician enter results and generate the report within the system? Does the report go back to the doctor's dashboard automatically?
- External lab integration. If you send samples to a reference lab, can results be imported?
- Ask to see a real report. Not the demo data — a report generated from actual usage. Revenue by department. Patient volume trends. Doctor-wise billing. If the vendor says "we can customise reports," ask how long customisation takes and what it costs.
- Can you export data? To Excel, to CSV, to PDF. This matters more than people think. Your CA will want billing data in Excel. Your management will want dashboards. If the system locks data inside and only shows it on-screen, that's a problem.
- Patient portal or app. Can patients see their own records? Book appointments online? Download prescriptions and reports? This is increasingly expected, especially by younger patients.
- SMS and WhatsApp notifications. Appointment reminders, report ready alerts, follow-up reminders. Do these work? What do they cost per message?
AI in healthcare software is mostly marketing in 2026. But a few applications are genuinely useful:
- AI-generated discharge summaries. This saves doctors 15–20 minutes per discharge. Ask for a demo — the quality varies wildly between systems.
- Drug interaction checking. Useful and relatively straightforward.
- Radiology and lab AI. AI-assisted readings for X-rays, automated lab result flagging. Ask what AI model they use, what it costs per use, and whether there's a credit limit on your plan.
ABDM (Ayushman Bharat Digital Mission) is India's national health data infrastructure. It's not mandatory yet for private hospitals, but it's heading that direction.
- Can the system create and link ABHA IDs? (Health IDs for patients)
- Does it support health record sharing via ABDM consent flow?
- Is the vendor actively working on ABDM compliance, or is it "on the roadmap"?
"On the roadmap" usually means 12–18 months away. If ABDM matters to you, ask for a timeline with specifics.
- Multi-branch support. If you have (or plan to have) more than one location, can all branches run on the same system with shared patient records? Or is each branch a separate installation?
- Mobile access. Can doctors access the system from their phone? What works on mobile — just viewing, or also prescribing?
- What happens when the internet goes down? (For cloud systems.) Is there any offline capability, or does everything stop?
- Uptime guarantee. Ask for their uptime over the last 6 months. If they can't answer, that tells you something.
- Data ownership. If you decide to leave, can you export all your data? In what format? How long does it take?
These are the ones that bite you six months in:
- What does onboarding look like? Who enters your existing patient data? Who trains your staff? How long does it take to go live? Is there a cost?
- What does support look like after onboarding? Response time? Phone or just email/ticket? Weekends and holidays?
- What's the pricing in year two? Some vendors offer discounted first-year pricing. Ask what it costs when the discount expires.
- Can you talk to two or three current customers? Not references the vendor cherry-picked. Ask if you can speak to a hospital of similar size that's been using the system for at least six months.
The best HMS for your hospital isn't the one with the longest feature list. It's the one your staff will actually use every day — and the only way to know that is to test the workflows that matter to you, with your data, in your environment.
If you're evaluating EMR systems and want to run through this checklist with ShylCare, we'll set up a demo using your real workflows — not a scripted walkthrough. Book a slot here.