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Smaller Practices Pressured into Selecting Health System’s Hand-Picked EHR

February 23, 2015
by Gabriel Perna
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Black Book, a research firm based in Clearwater, Fla., found that most small offices and physician practices in a large health system buy directly from the CIO of their flagship hospital. 

The research firm surveyed 740 physician practices and found that that 93 percent that procured an EHR product directly from the CIO’s office of a flagship hospital felt obligated to only select that EHR from the hospital reseller. Those who said they had done so admitted fearing financial consequences from declining those EHR implementations including interrupted referral streams, segregation from clinician data sharing and accountable care organizations, and exclusion from important hospital communications.

Nearly 80 percent of physicians that replaced their original EHRs for a hospital's network EHR in 2014 felt the pressure to concede to the EHR the hospital that was reselling, or being ultimately left out of community health information exchanges, referral networks, physician alerts and patient portals.

Moreover, Black Book uncovered that those reselling the EHR systems, typically an IT manager at the health system, were grading product satisfaction and service on behalf of those smaller providers. Nearly half of the larger hospital channel partners were taking liberties in scoring the satisfaction of EHR products in network physician practices. Those who were doing so scored products on average up to 49 percent higher in satisfaction and 73 percent higher in vendor loyalty than the actual physicians and staff using the product.

“That is no different than soliciting a salesman to rate his own merchandise, which in turn leads to improved or influenced sales,” Doug Brown, managing partner of Black Book, said in a statement. “We determined it was judicious to disallow hospital channel partners from rating their physician clients’ satisfaction and loyalty, in order that Black Book could get a more accurate measurement of true user experiences in 2015."

As a result of finding this, Black Book will delay its annual top rankings of EHRs from the customary January to mid-March 2015. It plans to complete a resurvey and audits of over 3,000 more respondents.




Besides being left out - these practices would have difficulty attempting to connect with the large health system if they didn't use the pre-selected EHR. The large health system would already have connectivity planned/developed for the practices. Attempting to pick their own EHR they would have to petition the large health system to allow them to connect - a feat that is sometimes impossible to accomplish. Other priorities, not interested in investing time and resources are just some of the reasons large health systems wouldn't be expected to allow the small practices to choose their own EHR.


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