Large physician practices are starting to come around to the EHR, thanks to vendors' efforts to upgrade the platform with patient engagement, interoperability and population health tools, among other capabilities.
According to Black Book, which has surveyed provider attitudes toward EHRs for the past six years, 71 percent of physicians employed in practices of 25 or more doctors say they're happy with the advancements made by their EHR vendors to upgrade the platform. That's a far cry from the 92 percent in 2013 who were "very dissatisfied" with their EHRs.
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"Meaningful use guidelines, 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," Doug Brown, Black Book's managing director, said in a press release. "There was also a measurable shift in loyalty to vendors that offered a robust, core EHR to accommodate evolving reforms."
Brown said vendors are responding to providers' requests to adapt their products to a changing healthcare landscape – one that features more patient engagement and mobile tools, better connectivity outside the physical campus and the ability to analyze data to effect meaningful clinical outcomes.
"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," Brown said in the release. "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."
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The Black Book survey, of 1,304 large practices, found that physician satisfaction in their experience with EHRs has jumped from 8 percent in 2013 to 67 percent during the first quarter of 2015, while satisfaction with documentation improvements has risen from 10 percent to 63 percent and satisfaction with productivity enhancements has jumped from 7 percent to 68 percent during that same time period.
As for what they're looking for, physicians responding to the survey who use one of the top four rated EHRs say clinical workflow enhancements (60 percent), population health capabilities (33 percent) and updates and new releases (34 percent) helped improve their satisfaction with the platform.
In terms of specific EHR vendors, Black Book ranked Allscripts at the top for large practices of 26-99 physicians and more than 100 physicians, with the ranking based on 18 key performance indicators. Epic, eClinicalWorks and QSI NewGen also scored highly, as did multispecialty clinic and IPA-centric vendors Greenway, McKesson, athenahealth and Cerner. Also making the list was MCIS, a wholly owned subsidiary of the Wisconsin-based Marshfield Clinic.
Conversely, more than three-quarters of those surveyed were dissatisfied with their clinic-oriented EHR platform if it failed a regional connectivity test, indicating a high premium placed on interoperability and adaptation. Over all, Black Book officials said 18 percent of the large practices and clinics surveyed are replacing or talking about replacing their original EHR by the end of 2016.
In a nod to how far the market has come, the Black Book survey found that 71 percent of clinics and large practices who'd installed their EHR platform before the fourth quarter of 2012 were the most dissatisfied with their vendor's performance in 2015.
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