- Pundits may have designated 2013 as the original “Year of EHR Replacement,” but the accolade may have been a little premature as providers continue to make the difficult decision to rip out and replace existing EHR infrastructure at record rates. Just under 20 percent of large practices and clinics intend to undergo an EHR replacement by the end of 2016, says a new survey by Black Book Rankings, or have already started the process.
The annual ambulatory user satisfaction poll strikes a surprisingly positive tone, considering recent grumblings from physicians about poor usability, non-existent interoperability, and torturous workflows that disrupt patient care. In contract to a recent AMA and AmericanEHR Partners survey that put EHR satisfaction at an all-time low of just 34 percent, the Black Book poll indicates a sharp upward trend in the way users view the efforts of their vendors.
In 2013, 92 percent of multispecialty groups expressed displeasure with their EHR products and vendors, the survey says, but that number has flipped in 2015. Seventy-one percent of physicians polled this year believe that their vendor is “meeting or exceeding” their expectations for EHR optimization. Eighty-two percent of administrative staff also believe they have seen improvements in the operational or financial capabilities of their practice management and EHR software.
Black Books notes that the four highest-ranked vendors - Allscripts, Greenway, McKesson, and athenahealth - have all made significant investments in user experience and client satisfaction over the past year, securing their places at the top of the EHR “most wanted” list. Sixty percent of providers who use products from these four companies agree that they have seen clinical workflow enhancements, while a third say that their vendors have adequately invested in population health management features that will aid the ongoing transition to value-based care.
Ninety percent of providers said that their vendors have solicited user feedback to improve the EHR experience. However, more than a quarter of users say their vendors have failed to make similar efforts to improve the implementation and training process. Eighty-five percent reported a negative opinion on the ability to receive adequate customer service.
Even though providers are becoming more likely to commend their vendors for improvement efforts, that isn’t stopping customers from jumping ship. Seventy-one percent of providers who implemented an EHR prior to the end of 2012 reported high levels of dissatisfaction with what might accurately be termed “legacy systems,” even just three years later.
Numerous mandates and healthcare reform initiatives are leading providers to demand more from their technology, and vendors are still lagging behind their customers’ needs for health information exchange, patient engagement, and productivity boosters.
"Meaningful use deadlines, total integration and reliable delivery may have influenced large group practice buyers to purchase initial EHRs from 2010 through 2013, but replacement buyers sought better EHR tools in 2014 that include patient engagement, true interoperability, enhanced usability and productivity gains," said Doug Brown, Managing Partner of Black Book. "There was also a measurable shift in loyalty to vendors that offered a robust, core EHR to accommodate evolving reforms."
"EHR firms with a wide offering of products including health information exchange, population health tools, revenue cycle management services, patient portals, dashboards and analytics are emerging as the next wave of healthcare technology leaders," added Brown. "These leading vendors are assisting their clients in assessing current practice operations to meet the demands of ICD-10, payment reform, connectivity beyond closed networks, revenue cycle management gaps, and population health tools, and recommending effective options within the same vendor suite."
Thirty-eight percent of primary care and specialty providers practicing in large groups have failed to return to pre-EHR productivity levels, the poll found, while only 53 percent of surgical specialists reported any productivity enhancements over 2014 levels.
Allscripts took the top spot in user satisfaction among ambulatory providers with more than 26 practitioners, squeezing past Epic Systems, eClinicalworks, and QSI NextGen. This is the second year in a row that Allscripts has been ranked number one among provider groups with 100-plus practitioners.