Best in KLAS: The Time is Now

Tate notes that GE Healthcare, whose overall score fell another 15 percent, has been up front with its customers that Centricity had some problems that the company needs to fix. “They lost a large portion of their customer base,” he says. They have worked with Intermountain and Microsoft on some innovations, but it remains to be seen when those might come to market.”

Dan Kinsella

Seeing Epic’s success, some in the industry question whether its growth is sustainable. Yet one Epic customer, Dan Kinsella, CIO of Cadence Health, a two-hospital system in the suburbs of Chicago, believes that the company simply made a bet about the way the market would develop and “built a better mousetrap.” Other vendors tried the acquisition and roll-up strategy, he says. “I joke that some of these systems are integrated at the invoice level, but when you look underneath the covers, they aren’t really integrated.”

The Ambulatory Market

KLAS has noted that the ambulatory EMR market expansion brought about by the Health Information Technology for Economic and Clinical Health (HITECH) Act has found the top vendors racing to keep current clients on board while also engaging new ones. The expansion also has opened up opportunities to a wider range of vendors.

More large physician practices are making the decision about their ambulatory EMR based on the acute care EMR in use in their network or affiliated hospital because they want interoperability across those settings. This is especially true for the Epic and Cerner acute-care EMR customers. Yet some innovative vendors continue to pick up new customers. NextGen has managed to move up in the rankings from fifth to third place in the rankings, Tate notes, and eClinicalWorks is very physician friendly and they are a nimble company, he adds. (eClinicalWorks ranks No. 2 in the ambulatory market for physician groups with more than 75 physicians.)

Allscripts’ ratings have continued to slide a bit. Following its merger with Misys a few years ago, the company lost a little bit of focus, Tate says. “They still have a huge client base and those customers are still hopeful they can turn it around.”

A few vendors, such as Greenway and LSS, have shown the potential to move up to the niche serving larger physician practices. “Greenway already has some larger customers who report having a good experience,” Tate says.

As provider organizations continue to consolidate, the ambulatory vendors will be forced to chase fewer larger customer, notes Judy Hanover, research director for IDC Health Insights in Framingham, Mass. “We haven’t seen too many consolidations on the vendor side yet, but I think we will see more over the next few years,” she adds. In the ambulatory setting, the smaller players have been buoyed somewhat by the meaningful use financial infusion, she adds. But when it comes time to for customers to renew their technology, some of those players may not survive.

Judy Hanover

As providers continue to seek ways to do more with fewer resources, software as a service (SaaS) solutions are appealing to more of them. For instance, athenahealth has made a real splash in the smaller-office market, Tate says. “Their SaaS model has been disruptive,” he adds. “It is lightweight, and they have been taking good care of their customers.”

One of those customers is seven-physician Pioneer Valley Pediatrics in Longmeadow, Mass. It has been using athenahealth’s practice management system for seven years and has been on the clinical system for three years.

“This was a fairly new product, so in a way we were taking a chance,” says Sally Ginsburg,  M.D., of Pioneer Valley. “But we already knew the company well. All we had to do was buy laptops and install wi-fi. It really limited the amount we had to spend up front. We did not have to hire an IT person.” She says that so far the practice’s experience with the solution has been great. “We attested to meaningful use Stage 1,” Ginsburg adds, “and are in good shape to do Stage 2.”

Emergency Department

In the Emergency Department software space, the tension still exists between going with the module of the core EMR or using a best-of-breed solution such as Wellsoft EDIS, which moved into the No. 1 ranking spot. “In Cerner and Epic shops, there is pressure to use all of their pieces,” Tate says. “When we survey CIOs, there is a strong preference for that. But when we talk just to the ED doctors, the ranking is quite different. They feel they are giving up a lot by going with the EMR’s module. That battle has also been fought in surgery and pharmacy, and is largely over. For the most part, no one goes with a best of breed in those.”