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Larger Physician Practices More Likely to Be Satisfied EHR Users

Nearly two-thirds of physician practices with more than 25 clinicians surveyed commended the enhancements in functionality, service, and innovation with top ranked vendors in Q2 2015. Multispecialty clinics, IPAs, and large group practices narrowed down an elite group of EHR systems across 18 probing key performance indicators from a field of over 400 qualified EHRs.

Black Book conducted its annual ambulatory user poll to determine the highest ranked EHR and EMR organizations for 2015. As part of a special research focus on several specialty physician EHR users, Black Book Rankings surveyed the clients of EHR vendors with the highest scores in customer experience in the areas of document management, productivity, practice administration, reporting, interoperability, and order entry and decision support.

Black Book identified a shift upward in physician experience across the large practice and clinic sector, since first measuring EHR satisfaction six years ago. In 2013, 92% of multispecialty groups using electronic records were "very dissatisfied" with the ability of their systems to improve clinical workload, documentation, and user functionalities. In 2015, comparably, 71% of all large practice clinicians stated their optimization expectations of top ranked Black Book EHR vendors were being met or exceeded according to physician and clinician experience. Eighty-two percent of administrative and support staff declared upgraded operational and financial developments, as well.

The top four ranked EHR vendors focused on the large group practice sector of medical care delivery: Allscripts, Greenway, McKesson, and athenahealth recorded the largest increases in client satisfaction over the past 12 months.

According to Black Book survey results of 1,304 large practices, overall satisfaction improved as follows:

• Physician experience satisfaction improved from 8% in 2013 to 31% in 2014 to 67% in Q2 2015.

• Physician documentation improvements improved from 10% in 2013 to 28% in 2014 to 63% in Q2 2015.

• Practice productivity enhancements improved from 7% in 2013to 17% in 2014 to 68% in Q2 2015.

• Users of the top four ranked EHR systems agreed that vendor investments in 2014 and 2015 have attributed update and releases (34%), practice assessments (44%), clinical workflow enhancements (60%), revenue cycle management and analytics value adds (89%), population health capabilities (33%), and solicited physician feedback (90%) have contributed the most to their rise in overall system satisfaction.

• Significant decreases in satisfaction were also noted by users of several clinic oriented EHR users that failed in regional connectivity attempts (76%), implementation and training (77%), and customer support (85%).

"Meaningful use deadlines, 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," says Doug Brown, managing partner of Black Book. "There was also a measureable shift in loyalty to vendors that offered a robust, core EHR to accommodate evolving reforms."

Among those surveyed, Black Book revealed 18% of implemented large practices and clinics are in the discussion or execution stages of replacing their original EHR by 2016 year end.

Opportunities for product penetration among current client bases of the top ranked EHR vendors was also recorded in the 2015 survey.

"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 health care technology leaders," Brown says. "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."

According to large practice executives and physicians, the primary reasons for top vendors succeeding in product penetration into their current client bases in the second half of 2015 include client education (42%), product bundling (31%), and marketing (26%).

Based on the aggregate client experience and customer satisfaction scores on 18 key performance indicators, Allscripts ranked first across all surveyed EHR systems for large practice categories of 26 to 99 physicians, and 100+ physicians. This is the second consecutive year Allscripts has achieved the top ranking for 100+ physician groups including independent practice associations, multispecialty clinics, academic practices, and large group clinics.

Allscripts also ranked in the top spot for 26to 99 physician group satisfaction for the first time, surpassing Epic Systems, eClinicalworks, and QSI NextGen who have alternated top rankings in the past few years.

Other top scoring multispecialty clinic and IPA centric EHR vendors included in the Black Book survey process since 2010 are Greenway, McKesson, athenahealth, and Cerner.

MCIS, a wholly-owned subsidiary of Marshfield Clinic (Wisconsin) also ranked in the top echelon of large practice EHRs in Q2 2015, their first appearance in the annual polling.

Other findings include the following:

• Clinics and large practices implementing an original EHR prior to Q4 2012 were the most dissatisfied (71%) with their EHR vendor's performance in 2015.

• Sixty-two percent of primary care and medical specialists in large group practices report a return to normal levels of productivity after rolling out their EHR systems. Fifty-three percent of surgical specialists in large group practices reported productivity enhancements over 2014.

Source: Black Book Market Research