Many dissatisfied physicians to switch EHR vendors


Christy Valentine, MD, a family physician at the Valentine Medical Center in New Orleans, adopted her first electronic health record system in 2007. After five years of trying to tweak and customize it to meet her needs, she decided to shop for a new system.

A survey showed that Dr. Valentine isn’t alone in her EHR dissatisfaction becoming so great that adopting a new EHR system was worth taking the financial hit.

In February, Black Book Rankings, a technology market research firm in Clearwater, Fla., released results of its annual survey of nearly 17,000 physicians and others who are active EHR users. Seventeen percent plan to switch vendors in 2013, 6% want to change but have no time frame, and 8% would like to alter their courses but can’t afford to do so.

The findings were similar to a report published in July 2012 by EHR market research firm KLAS. About half of 300 practices in the market for an ambulatory EHR system were not first-time buyers. The number of practices shopping for a replacement EHR jumped from 30% in 2011 to 50% in 2012.

“Meaningful use incentives created an artificial market for dozens of immature EHR products,” said Doug Brown, managing partner of Black Book Rankings, in a prepared statement. The market has become saturated, and the vendors that will remain viable will address the needs of practices, he said.

Why so much dissatisfaction?

One of the biggest complaints, especially among specialists, is that too many products are “one size fits all” and not customized to meet their needs. Dr. Valentine’s EHR was designed with hospital clients in mind. “The system wasn’t as friendly for an outpatient setting,” she said.

Topping the list of reasons that some practices plan to switch is unmet expectations. Eighty percent said their systems were not meeting their needs, including workflow. However, respondents weren’t putting all the blame on EHR vendors. Black Book Rankings reported that 79% said they did not assess their needs adequately before selecting their original EHR systems.

Derek Kosiorek, principal with the MGMA Healthcare Consulting Group, said many clients blame their systems instead of looking for ways to improve how they use them. He recommends that physicians find other practices using the same systems to see if any are having success. If they are, it’s worth talking with the practice to see how they use the EHR appropriately and efficiently, he said.

Black Book Ranking’s survey also gauged the popularity of Web-based EHRs. Fifty-one percent of the practices that were changing their systems or considering doing so said they use Web-based systems and plan to convert to another such system. Nineteen percent were switching from on-premises systems to Web-based ones. These changes indicate a health care environment that has become more mobile.

Kosiorek cautioned that it might not be a good time to buy, because the market is going through a transformation. He said older, more established vendors are still building locally hosted systems even though the industry is moving toward cloud-based technology that can be used from a variety of devices. Newer vendors have the technology but are finding it hard to break into a market dominated by large vendors, he said.

During the next few years, Kosiorek said he expects mergers and acquisitions to continue, and that may bring some innovations to older vendors.

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