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Survey: Specialty-Driven EHRs Are a Growing Trend in Physician Specialty Practices

June 7, 2016
by Heather Landi
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According to a recent survey by market research firm Black Book, 86 percent of specialist surgical and medical practices reported that the biggest trend in physician technology replacements has swung back to specialty-driven electronic health record (EHR) systems.

Black Book surveyed 11,300 independent physician specialty practices in the first and second quarter of 2016 for its 2016 Ambulatory EHR user survey for customer satisfaction and loyalty. According to the survey, specialists are looking to end chronic replacements with flexible cloud-based and specialty-driven EHRs tailored to improve financial, workflow, clinical outcomes and satisfaction.

The survey found that 85 percent of specialist physicians agree that first generation EHRs have not lived up to expectations, particularly dissatisfied with cost add-ons, affected workflows, and lost time with patients. Current 2016 satisfaction and loyalty among specialty-driven EHRs has improved to 80 percent moderately-to-highly contented users with their replacement system when comparing their first chosen EHR solution.

And, 48 percent of all specialty practices that switched EHRs between June 2014 and April 2016 report the financial burden of changing EHRs has put the practice in an unstable financial position. The survey also found that 66 percent of specialists changing systems report only reviewing cloud-based EHRs in 2016-2017 for the cost factors.

Eighty-two percent of specialists reported that they rushed to implement their original system before incentive deadlines, and 93 percent admitted to having failed to fully vet their original EHR vendor, according to the survey report. In addition, 79 percent also stated their meaningful use incentive payments did not offset capital and personnel costs associated with the EHR implementation.

Recent EHR replacement changes have been fueled by specialist workflow and productivity complications that left no time for physicians to customize their generic, multi-use HER, according to 92 percent of surveyed respondents.

“Purchasing a specialty-driven system was the most effectual path to resolve ultra-specific functions, quality reporting needs, and produce reimbursement support,” Doug Brown, managing partner of Black Book, said in a statement.

Almost one-third of independent specialists switched EHRs from their original implementations in favor of a comprehensive multi-use EHR because they perceived limited market-sized (specialist-specific) EHRs may lead to compromised growth and stability in their practices.

In 2010, 80 percent of specialist physicians found the system configurability and flexibility was moderately to highly unsatisfactory. “Specialty-specific EHRs didn’t all offer the reliability and flexibility of the large multi-use and primary care-centric EHRs,” Brown said.

Improvements in web-based EHRs including implementations, updates, usability and customization have reversed overall EHR satisfaction in practices of 6-25 physicians from barely 13 percent meeting or exceed expectations in 2012, to 85 percent overall contented specialty-driven EHR users in the second quarter of 2016.

Lack of interoperability with other providers, particularly inpatient facilities, continues to be a concern for 88 percent of specialist physicians. “As many specialty-specific EHRs have not fit well within garden-walled, hospital-networked, payer and public health information exchanges, they have been rendered unable to compete with the large multi-specialty EHRs,” Brown said.

“The global finding is that specialty-driven, not necessary specialty-specific EHRs are on the fast track for specialist system replacements,” Brown stated. “Notably, well-constructed multi-specialty EHRs with strong market presence have accommodated dozens of specialties through flexible functioning and incorporated plugins.”

The bigger issues of interoperability and population health outcomes, quality of care reporting, MACRA and ICD-10 have framed the third generation EHR vendor, and the majority (77 percent) of specialty practices plan to increase their investment in the advancements made by their current EHR vendor.

According to Brown, as risk sharing increases, so will the demand for meaningful data sharing between specialist providers and payers regardless of the model EHR employed. “If the interfaces for interoperability between the HIE and stakeholders is too difficult to evaluate and analyze risk, the more likely we will see another round of EHR replacements, cloud and server based,” Brown said.

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