Never before has the ambulatory EHR landscape been of such importance to the acute-care CIO. With the relaxation of Stark a few years ago, some savvy health systems began underwriting EMRs to independent practice in their areas. While HITECH threw the market a curve ball that temporarily slowed down the Stark snowball, it has recently picked up apace. Most now realize that integrating with local physicians, and the guaranteed patient flow they constitute, is all-important to maintaining a robust market presence in the coming decades. To learn more about how HITECH and Stark are effecting ambulatory EHR vendors, HCI Editor-in-Chief Anthony Guerra caught up with NextGen President Pat Cline.
GUERRA: Let’s talk a little bit about your KLAS scores. Both your scores and your primary competitors scores seem to be trending downward. What do you make of that, and what, overall, do you think of KLAS scores?
CLINE: We pay attention to our KLAS scores but, frankly, we pay far more attention to our own internal studies. We have a dedicated department of people within NextGen Healthcare that survey every customer – not with a written survey so that they only get so many back – but a department of people whose jobs it is to get every customer on the telephone during the implementation, after the implementation, and then periodically thereafter, and we poll our customers on all kinds of different quality and customer satisfaction metrics. We do that because we’re very serious about quality and serious about customer satisfaction, but again, we do pay attention to the KLAS scores.
I think there are some nuances to reports or third-party surveys like the KLAS report that people need to understand. For example, if one system has hypothetically 500 features and another system has hypothetically 20 features, you may find that the customers are purchasing that 500-feature system would have slower implementations, so there would be more difficulty implementing that type of system than a very simplistic system.
So for example, if NextGen Healthcare’s system comes with interoperability to community data exchanges, and provides PQRI reporting through registries, and supports Patient Centered Medical Home, and interfaces to Quest and Labcorp and other hospital labs; and another system that might get delivered to the same size practice doesn’t support any of those things or has very, very limited support, it may be that that system – the less feature-rich system – is far easier to implement, and would probably fair better in the KLAS survey or ranking than a system that’s extremely feature rich.
That’s not an indictment of KLAS but more to point out the nuance and the reason we feel it’s critical for us to maintain that department of people who poll our customers with all the metrics that we feel are important.
GUERRA: Do you speak to KLAS about your scores?
CLINE: We do.
GUERRA: So they’re willing to have those conversations.
CLINE: Yes, they’re very open to having conversations. They’re doing the best job they can and it’s impossible for them to cover all of those nuances and to adjust for them.
GUERRA: You’ve singed a number of big deals lately. With the healthcare IT worker shortage in mind, do you have to make sure you don’t take on too much? Do you ever get to the point that you shouldn’t take on another big deal?
CLINE: Yes, we do get to that point and I think we have, in fact, throughout our history turned deals away when we feel we’re not in a position to do a good job, a good quality job. I do see the potential for an increase in the number of deals we turn away. If we can’t do a good job or if we sold too many to where we can’t render training and implementation services on a quality basis, nor can we lean on some of the third-party consultants that you talked about earlier, it’s far better for us to turn the business away than it would be to execute an agreement and do a lousy job. It costs us far more with respect to our reputation, and in many other areas, than we would make on a given deal or sale.
In order to combat what may in the future (and frankly, a lot of our competitors are hoping) will be a tremendous shortage of available personnel, we are doing a lot of things that I mentioned previously. We’re working very hard to make our software easy to use and, in fact, the easiest. We invest a lot in our computer-based training. We do certify third parties. We have opened training centers across the country that help us leverage, for example, one trainer across multiple practices being trained at a time.
GUERRA: How do you protect the good people you have from being poached, and how do you find the people you’re going to need?
CLINE: Well, no one knows how bad it’s going to get, but certainly there’ll be a lot of poaching going on. I think those companies that treat their employees very well in many respects, financially and with respect to recognition and incentives, will fare better. We’re proud that we’re consistently voted in our respective regions as one of the top 10 places to work, and those awards and accolades are based on independent blind employee surveys.