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Are Industry Rankings Really Indicative of EHR Usability?

A conflict between EHR usability and industry rankings seems to be emerging, highlighting issues with how EHRs are ranked.

By Sara Heath

- A high ranking for an EHR might not be indicative of its actual usability. This becomes clear when one compares recent industry rankings with polls and testimony coming straight from users.

EHR usability industry rankings

Just last week, KLAS released its Best in KLAS rankings, with Epic Systems clearly coming out on top. Taking home two overall rankings and seven other Best in KLAS rankings, the EHR vendor giant continued to assert its dominance in the health IT industry.

However, these rankings come in light of several user complaints surrounding the EHR.

Last October, Epic was ranked last for EHR usability in an emergency department in a Black Book poll, which takes the considerations of EHR users and puts them directly into their results. The poll found that users found Epic, along with other mainstream and typically high-ranking EHRs, as too generic for ED needs.

This problem applies to more EHR vendors than just Epic. In an August poll conducted by peer60, providers cited EHR usability amongst all vendors as one of their top concerns in healthcare.

In total, 54 percent of surveyed providers are unhappy with their EHRs. While 54 percent may not be a staggering number, as the healthcare industry increasingly shifts to a technology-based format, it is reasonable to expect that significantly more than half of users would be pleased with their products.

Other studies confirm these complaints. A year-old study from Frost & Sullivan shows that EHR usability is a considerable pain point for most healthcare CIOs.

This study showed specific issues CIOs are having, like searching through the EHR for specific data points. Between the slowness of the technology and difficulty to filter through irrelevant search results, providers are having a tough time finding the information they need in their EHR.

The study also indicates that these difficulties are the result of poor EHR development and not necessarily inadequate user training.

But still, these EHRs are getting high rankings in industry reports. In an October peer60 study, Epic, Cerner, athenahealth, and several other technology industry giants were commended for their innovative platforms.

Could this discrepancy highlight an issue within the industry? Although users are constantly complaining of EHR usability, and those complaints are being confirmed by studies that say these issues aren’t the fault of the users, EHR vendors are still getting high praise in industry reports.

This also calls into question the role meaningful use plays in EHR development. If meeting meaningful use requirements is a part of how EHRs are ranked in industry reports, then the larger vendors who are able to afford meeting these criteria (such as large and usually well-ranked vendors like Epic and Cerner) will surely benefit.

If meaningful use requirements do play a large role in rankings, that may also explain the conflict between user-reported usability issues and industry rankings. Several users claim that meaningful use requirements, and therefore much of the criteria their EHRs need to meet, present several workflow complications.

This conflict of EHR development may be alleviated as the Centers for Medicare & Medicaid Services (CMS) begins to adjust some of its meaningful use goals.

Earlier this year, CMS’s acting administrator Andy Slavitt announced that the agency will aim to make the program more focused on provider goals and patient outcomes. Part of this will be centered on EHR vendor freedom to develop the products that providers are saying they want and need.

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