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Physicians Frustrated with EHRs, but Most won’t Replace Systems

October 10, 2016
by Rajiv Leventhal
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Not surprisingly, Epic leads all vendors as the EHR market for acute care facilities is consolidating quickly

Another report on physicians’ frustrations with electronic health records (EHRs) points to challenges with the systems’ usability and functionality. However, providers don’t see great alternatives on the market, according to market researcher peer60.

The survey from August included more than 1,000 physicians who gave their perspective on the state of the market. Three-quarters of respondents were in ambulatory settings, while the remaining quarter were in the acute care space. Eight-five percent of respondents indicated that they have an EHR, and not surprisingly, the majority of the “have-nots” in terms of EHR adoption are small clinic organizations that often believe they don’t need an EHR (or just can’t afford one).

When it comes to acute care participants, the market leaders were also not surprising: Epic (50 percent), Cerner (21 percent) and Allscripts (9 percent) each distinguished themselves by garnering a significant amount of support. Epic has not been able to box out its competitors entirely, according to the report. Meanwhile, in the ambulatory EHR market, Epic (18 percent) had almost three times the installs among participants than the next closest supplier, Allscripts (7 percent), the findings revealed.

What’s more, the market for acute EHR replacement is small, but some opportunity yet remains. Nine percent of acute facilities are actively looking to replace their current EHR. Scores found in this study are just the industry standard with no significantly better options available (like in the airline industry), the researchers noted. They said, “Given the amount of money involved in a single EHR deal, this still represents significant potential for new revenue; But the market is clearly settling down with few facilities interested in making a change in any given year.”

The report further stated that Epic customers are holding onto its clients, while Allscripts and Cerner are “playing a little bit of defense.” It said, “Epic continues to pick up market share, though its numbers here are probably helped by the skew toward larger acute facilities. Still, there is no doubt which company leads this market right now,” the report said.

For Cerner, its mindshare (30 percent) is materially above its current market share (21 percent), so the potential for growth exists. This growth appears to be driven in large part by community hospitals as opposed to integrated delivery networks (IDNs), the researchers said, pointing to some of the key IDN battles Cerner has won such as Intermountain Healthcare and the Department of Defense. “Indeed, Cerner has become very competitive in this segment of the market, and all signs point to Cerner giving Epic a real run for its money,” it said.

Similarly in the ambulatory market, most providers aren’t planning replacements; just 11 percent reported having plans to ditch their current EHR supplier. “However, if things stay as they are, physician dissatisfaction will metastasize to encompass the majority of the organization and replacement rates will almost certainly increase in coming year,” the report said.

The findings further showed that 98 percent of Epic users and 89 percent of Cerner users in the acute care space reported that they are not looking to replace their systems. Meanwhile, the acute care replacement market among medium to large organizations looks to be a two horse race between Epic (61 percent) and Cerner (30 percent). On the ambulatory side, the top suppliers for potential replacements is more spread out, through Epic (34 percent) and Cerner (19 percent) still rank as the top two. athenahealth (17 percent) ranked third.

And for those in the acute care space who are looking to leave their current provider, a trend is emerging: ease of use (71 percent) is the biggest and most important feature followed quickly by additional functionality (58 percent). “These challenges make clear that the problems causing acute facilities to change suppliers are not confined to those actively looking. Rather, the frustration with usability and lack of functionality is industry-wide,” the report stated. Similarly on the ambulatory side, 67 percent of providers put usability as the top challenge, and 58 percent put missing functionality.

Going forward, a top priority (30 percent) among physicians is having access to better patient satisfaction data. Accountable care (25 percent) and alternative payment models (22 percent) came in second and third, respectively.

“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,” the report concluded.

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