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Report Takes a Look at Potential Components of "Meaningful Use"

As the HIT industry awaits a formal definition for the meaningful use of electronic medical records (EMRs), HIT research firm KLAS has released a comprehensive report outlining which EMR products are best positioned to achieve whatever meaningful use standard is adopted. The report, “Meaningful Use Leading to Improved Outcomes,” takes a broad look at the EMR market, assessing how well core clinical vendors are delivering solutions for computerized physician order entry (CPOE), nursing automation, medication administration, and other key areas.

“Since the introduction of the stimulus package and its provisions for health IT, much of the market rhetoric and industry debate has centered on the concept of meaningful use—what will it entail and how will it impact the receipt of stimulus dollars,” says KLAS Founder and Chairman Kent Gale. “Whatever the final definition of the term, if improved patient outcomes are indeed the ultimate goal, then some form of clinician adoption will be critical. In particular, deep adoption among physicians is pivotal to the overarching success of an EMR implementation.”

The KLAS report notes that while EMR vendors Cerner, Eclipsys, and Epic are the most successful with regard to physician adoption, Meditech has the largest number of clinical information system (CIS) customers over 200 beds (327 hospitals), followed by Cerner (263) and McKesson (242). However, the Meditech customer base, encompassing the MAGIC and C/S product lines, has the smallest number of hospitals over 200 beds with deep CPOE adoption—that is, where more than 50% of all orders are entered electronically by doctors. Only 3% of Meditech customers have achieved this level of adoption. Among the CIS market share leaders, McKesson exceeds Meditech in this area with 5% of its customer base enjoying deep adoption, while Cerner leads both McKesson and Meditech at 23%. GE, QuadraMed, and Siemens also enjoy some success with CPOE adoption.

Beyond CPOE, the report also evaluates vendor offerings for nurse charting, an electronic medication administration record, patient-monitor interfaces to the EMR, electronic flow sheets, and barcoding at the point-of-care for medication administration. For each solution area, KLAS evaluates the risk the vendor poses to provider customers who want to achieve a comprehensive EMR implementation.

No vendor is perfect in every area, but Cerner and Epic are the strongest, followed by Eclipsys. Within this threesome, only Cerner extends to really meet the needs of both larger facilities over 200 beds and some community hospitals. Meditech has a broad install base across all hospital sizes and covers virtually every aspect of automation, with nurses using the product across the country; but Meditech’s Achilles’ heel is the lack of adoption by physicians. Other vendors deliver functional solutions but face a variety of challenges that have hindered deployment, such as the lack of tight integration among McKesson’s core clinical modules or Siemens Soarian clients awaiting version C6 availability.

In light of these challenges, however, some providers are reporting that new versions of several EMR products are eliminating some of the historic issues. McKesson Horizon 10.1, Meditech 6, and Siemens Soarian C6 all represent new product upgrades, each with the potential of improving CPOE adoption rates and integration issues. Soarian C6, already live in at least one hospital, is reported to remove a painful CPOE software issue with an immediate impact of additional doctors now entering orders. Specific CPOE adoption and integration improvements related to the latest versions of McKesson and Meditech EMR products have not yet been reported to KLAS.

Nine EMR vendors are specifically profiled in the new KLAS report: Cerner, CPSI, Eclipsys, Epic, GE, McKesson, Meditech, QuadraMed, and Siemens.

Source: KLAS