Loyalty rankings: Epic, MEDITECH clients feel 'trapped'; Cerner, athenahealth clients 'most loyal'

Epic and MEDITECH clients appear less satisfied with their vendor relationships than Cerner clients do, according to the 2016 Black Book Inpatient EHR Surveys.

The surveys gathered responses between the second quarter of 2015 through the first quarter of 2016 from EHR users nationwide on their experience and satisfaction with their service providers.

In this year's loyalty index, degrees of loyalty were broken down into quadrants: "most loyal," "reachable," "trapped" and "top risk."

Overall, the loyalty percentage score of all vendors combined, calculated by an average of loyalty key performance indicators (renewing current contract, purchasing more products and services and advocating for peers to purchase), fell 8 percent from 2015 to 2016. Doug Brown, managing partner of Black Book Research, says this can be attributed to EHR vendors not delivering on promised initiatives and lack of support on "value-adds" like revenue cycle management and population health, among others.

"Providers expected interoperability from their EHR vendors, not regional, closed system connectivity, but realizable, open systems," Mr. Brown says. "It's been a major EHR disappointment for hospitals."

Allscripts, Cerner, Evident CPSI, athenahealth and T-System placed in the "most loyal" quadrant, meaning clients intend to maintain the business relationship and have a positive attitude toward the vendor. Additionally, clients reported being likely to increase spending on other products and service lines from these vendors.

McKesson was the only vendor among the "Reachable" loyalty quadrant, characterized by clients with a good attitude about working with the company but no plans to enhance the business relationship.

Epic and MEDITECH were the two vendors in the "trapped" quadrant, which Black Book defined as customers with intent to continue business with the vendor, but are dissatisfied with some important aspect of the relationship. "They feel trapped in the relationship, many times because of large capital expenditures already made, contractual obligations or regional dictates, which make doing business with this EHR imperative for interoperability or ACO development," according to the survey. "This is common with hospitals locked into long-term agreements making it too hard to switch EHRs."

Overall loyalty percentage for Epic customers fell from 89 percent in 2015 to 80 percent in 2016. Indicative of Epic's "trapped" categorization, 98 percent of clients reported they were renewing current contracts, but 72 percent said they would advocate for peers to also purchase the product, the largest gap between these two indicators for all the vendors.

Mr. Brown says while the data are only indicative of what survey respondents say and not an analysis, he attributes this disparity to a shift in the vendor replacement activity. "There is a considerable amount of feedback that vendor replacement frenzy is calming except in the small market (hospitals under 100 beds) sector where Epic is not known to be competitive," Mr. Brown says. "Epic's standing in legacy, siloed system EHR is the Cadillac in the hospital industry."

Cerner's loyalty rankings increased from 88 percent in 2015 to 96 percent in 2016, and its key performance indicator averages were much more closely aligned: 96 percent of clients said they are renewing current contracts and 95 percent advocate for peers to also purchase Cerner products.

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