Physicians' opinions of EHR vendors: 13 findings

The latest report from healthcare technology market research firm peer60 finds physicians remain highly dissatisfied with their EHRs, some providers still seeking to switch vendors and Epic gaining traction in the ambulatory EHR market, making other vendors more vulnerable for replacement.

The report gathers responses from 1,053 physicians, in both acute care and ambulatory settings, who offered their perspectives on the current EHR market.

Here are 13 key findings from the report.

1. Fifty percent of surveyed acute care physicians use Epic's EHR. Cerner holds the second highest share, with 21 percent of physicians reporting using its EHR. Nine percent of respondents said they use Allscripts' EHR.

The report notes that physician respondents disproportionately represented large integrated delivery networks and larger hospitals, which may account for absence of vendors like MEDITECH that cater to smaller acute care facilities.

2. Among ambulatory care providers, Epic still was the most-used EHR by a significant amount, accounting for 18 percent of providers. Allscripts came in second, with 7 percent, and eClinicalWorks followed with 6 percent, Cerner with 5 percent and athenahealth with 4 percent.

3. The report found 9 percent of acute care hospitals are actively seeking to replace their current EHRs, and most of these hospitals are larger systems with more than 300 beds.

4. Just 2 percent of physicians at acute care facilities using Epic's EHR said they are considering replacing their EHR. However, 11 percent of physicians at acute care hospitals using Cerner and 26 percent of physicians at hospitals using Allscripts said they are seeking to replace them.

"The good news for Cerner is that its mindshare (30 percent) is materially above its current market share (21 percent), so the potential for growth definitely exists," according to the report.

5. Epic and Cerner are the most-considered suppliers to replace EHRs in the acute care setting, with Epic holding 61 percent of the replacement market share and Cerner holding 30 percent of the replacement market share.

6. There is slightly more EHR replacement activity in the ambulatory care market, with 11 percent of physicians reporting they are actively seeking to replace their EHRs. Epic does not appear to be in danger of being replaced in this market. Cerner is most vulnerable to be replaced among practices with between 11 and 50 providers (8 percent indicated they are looking for a new EHR), and Allscripts is most vulnerable to be replaced among practices with between 51 and 200 providers (6 percent).

7. How can EHR vendors save their contracts with acute care providers? The most frequently reported desire physicians want in their EHRs is easier usability (71 percent), followed by more functionality (50 percent). Twenty-one percent of respondents said they want lower costs and 33 percent said they want better customer service, suggesting users are most concerned with the software itself.

"This research makes painfully clear that opportunities abound for a vendor willing to innovate and make products easier to use for physicians," according to the report.

8. The report also breaks down top challenges with acute care EHR systems by vendor.

 

Usability

  • Epic: 50 percent of users indicated usability as a top challenge
  • Cerner: 83 percent
  • Allscripts: 83 percent

Missing Functionality

  • Epic: 50 percent
  • Cerner: 50 percent
  • Allscripts: 67 percent

Strategic Objectives

  • Epic: 0 percent
  • Cerner: 33 percent
  • Allscripts: 50 percent

Reliability

  • Epic: 0 percent
  • Cerner: 33 percent
  • Allscripts: 33 percent

Customer Service

  • Epic: 0 percent
  • Cerner: 0 percent
  • Allscripts: 33 percent

Other (examples includes connection with inpatient system, corporation that took over hospital uses another system, doesn't integrate with other systems)

  • Epic: 50 percent
  • Cerner: 33 percent
  • Allscripts: 17 percent

9. The ambulatory market had the top key challenges with their current EHRs as well, usability (67 percent) and missing functionality (58 percent). Thirty-four percent of ambulatory providers are considering Epic to replace their current systems, 19 percent are considering Cerner and 17 percent are considering athenahealth.

10. Physicians also shared top priorities and future needs, which peer60 suggests indicates what vendors should address next. Thirty percent of providers are seeking patient satisfaction data, 25 percent are looking at accountable care, 22 percent are looking at alternative payment models and 15 percent are looking at patient portals.

11. Among first-time ambulatory EHR adopters, Epic and Allscripts are tied for being the most considered EHR vendor, each with 21 percent of first-timers considering them. The main obstacle for first-time ambulatory facilities looking to implement an EHR is cost, with 46 percent saying they are too expensive.

12. The peer60 report calculated net promoter scores, which measures customer satisfaction by asking how likely physicians are to recommend their EHR vendor to a peer or colleague. The score is calculated by finding the difference in the percent of those most likely to speak negatively about a vendor (detractor) and those most likely to speak positively about the vendor (promoter).

Though the report does not offer net promoter scores for each vendor, it does offer de-identified data. Looking at Allscripts, Cerner, Epic and VistA, three of these vendors have more detractors than promoters.

13. "For now, the story is that caregivers are almost universally unsatisfied with their EHR system, yet they have very few expectations of anything better on the horizon, which is confirmed by a very low replacement rate," according to the report.

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