Electronic Health Records

Adoption & Implementation News

EHR Loyalty Shows User Satisfaction, Financial Investment

75% of providers feel EHR loyalty and are satisfied with their health IT products, a new Black Book survey finds.

By Sara Heath

- EHR user loyalty can take many forms, including those customers who are genuinely satisfied with their system to those who feel trapped within their system due to hefty monetary investments.

black book rankings

These varying levels of EHR and health IT system customer loyalty led Black Book to conduct its HIT Loyalty Index. By looking at not only customer behaviors but the motivation behind those behaviors, Black Book was able to discern several different kinds of loyalty and find those EHR and HIT products customers feel the most genuine devotion towards.

Looking at customer behavior and motivation also allowed Black Book to control for certain measures of satisfaction that often turned out to be insufficient and unusable for several client vendors.

“The motivation in creating a Loyalty Index was an early recognition by Black Book that the conventional metrics of customer affinity, namely satisfaction, repurchase intent, and client recommendations, were in isolation, insufficient metrics to full understand the complexities of EHR customer behavior and underlying motivating forces,” Black Book representatives wrote in a public statement.

Looking at customer satisfaction in this way helped Black Book examine two different kinds of customer loyalty – those who are satisfied with their products, and those who simply have high monetary investment in their products. These different levels of satisfaction cause customers to use their products differently in the long run.

“For example, a client whose customers have both high behavioral and attitudinal loyalty are different from those customers who are loyal because of capital investments in the EHR, but feel trapped,” said Black Book’s president, Doug Brown. “Customers who feel stuck in their EHR system can follow a downward decision making path towards eventual defection.  Highly loyal customers buy more IT products and service solutions as the EHR vendor adds more sources of revenue for the client.”

In the long run, these loyalty measures are intended to help vendors make better decisions about the design and development of their products.

“Customer loyalty has emerged as one of the most reliable metrics because of its forward looking nature,” Brown noted. “Using a customer loyalty metric to complement historical metrics such as sales, profitability, operational metrics and satisfaction key performance indicators helps hospitals and physicians make better decisions based on customer insights.”

Overall, the Black Book survey showed that customer satisfaction dropped by six percent in the course of the past year from 81 percent satisfaction to 75 percent satisfaction. About one quarter of those who are reportedly satisfied with their EHRs and health IT products are satisfied due to high capital investments rather than because of actual satisfaction.

Those vendors with the highest customer loyalty and satisfaction levels include Allscripts, Cerner, CPSI, NTT Data, and athenahealth/RazorInsights.

In the middle of 2015, Black Book released a similar survey, showing that EHR and revenue cycle management systems loyalty amongst small providers was on an upswing.

That survey showed Kareo as the leading integrated EHR and practice billing system for the third straight year due to its ability to meet the health IT needs of its users, including better interoperability, networking, and accountable care, among other things.

However, due to the considerable needs of small providers, EHR replacement is still a regular practice within the health IT marketplace.

“The majority (70%) of smaller and solo practice physicians have still not settled on a technology suite or set of products that delivers to their expectations on meaningful use, clinician usability, and coordinated billing and claims, hence, the relentlessly moving EHR marketplace,” Brown explained.

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