- The September 2017 KLAS report for emergency department information system (EDIS) usability showed provider leadership at organizations using Epic EHR have significantly higher rates of overall satisfaction than those using other enterprise vendor systems.
KLAS researchers attributed this success to the health IT company’s excellent support, relationships, and general experience.
However, Epic users reported lower rates of workflow satisfaction and usability compared to best-of-breed customers.
“Several Epic customers report excessive and repetitive clicking, back-and-forth navigation, and upgrades that create additional clicks; at the same time, users admit that these steps/clicks have helped improve patient safety, and respondents report that the vendor delivers more information at-a-glance,” wrote KLAS researchers in the report.
Epic is not the only enterprise vendor in need of usability improvements—researchers noted clinicians using all enterprise vendors expressed a desire for more efficient technology design requiring fewer clicks.
“While many Epic users are quick to acknowledge that CMS, insurer, and patient-safety requirements complicate the matter, best-of-breed vendors have been able to meet these requirements without an increase in clicks,” they wrote. “Multiple Epic customers point out that internal decisions and initiatives are at least partially responsible for preferences that increase clicks.”
Cerner customers in particular feel the health IT company has failed to deliver on usability improvements.
“One of the largest vendors with an ED offering, Cerner has made fewer impactful usability improvements than any other vendor,” wrote researchers. “While Cerner continues to gain new ED customers and delivers a better workflow for ED physicians than MEDITECH or Allscripts, users feel hampered by inconsistent training, reactive support, and a lack of the kinds of innovation that could improve physician satisfaction.”
Cerner has made efforts to reduce clicks through two tools meant to streamline documentation within provider workflows—Dynamic Documentation and PowerNote—but respondents report still being dissatisfied with the inefficiency and burden of clinical documentation.
MEDITECH users have also reported dissatisfaction with usability.
“Workarounds, system lag time, a confusing layout, and functionality geared more toward an inpatient environment are all complaints shared by multiple MEDITECH users who feel that considerable changes need to be made for the system to meet customer expectations,” they wrote.
Still, healthcare leadership at organizations using MEDITECH stated the technology has improved significantly compared to earlier versions.
“While many customers feel vast improvements still need to be made, they acknowledge the efforts that MEDITECH has made to make the system more functional, including enhanced customizability options and an improved workflow,” stated researchers.
Despite enterprise vendors such as Epic and Cerner continuing to dominate across a variety of specialized markets, best-of-breed vendors still set the bar for meeting ED provider expectations and needs for usability and functionality.
“As the market shifts and enterprise vendors play a larger and larger role, they will need to keep up with the standards set by the high-functioning, best-of-breed solutions,” wrote researchers.
Specifically, Wellsoft has consistently been named the ED Best in KLAS winner for 9 out of the past 10 years. Other best-of-breed vendors including T-System and Picis have received top marks in all areas of KLAS measures because of new technologies, customized ED workflows, and support.
MEDHOST has also consistently performed well overall, with some users reporting increased workflow satisfaction due to improvements to the order entry process in MEDHOST technology upgrades.
“With more and more provider organizations opting for better EDIS integration over ED-centered workflows, best-of-breed solutions are rapidly losing ground; but their streamlined, efficient software offers enterprise vendors a blueprint for what is possible,” they maintained.
Ultimately, enterprise vendors continue to lead the market because organizations opt for EHR integration over ED usability.
“While best-of-breed vendors stand out for technology, workflows, usability, and in many other areas, 42 percent of Wellsoft, 52 percent of T-System, 53 percent of Picis, and 51 percent of non-enterprise MEDHOST customers do not see their ED solution as part of their long-term plans.”
Organizations planning to abandon their best-of-breed solutions for large vendors are making the change in hopes of gaining better integration, cost savings, and improved continuity of care.
“While enterprise EDIS vendors are improving slowly, it remains to be seen whether they will be able to step up and provide the level of usability and physician-centered workflows that best-of-breed vendors have led many organizations to expect,” researchers concluded.