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KLAS: One Quarter of Ambulatory EHRs Could be Replaced

August 26, 2014
by Rajiv Leventhal
| Reprints

More than 25 percent of both large and small ambulatory practices report that they are considering replacing their electronic health record (EHR), according to the latest KLAS report on ambulatory EHR perception.

The report further finds that another 12 percent would like to replace their system but cannot do so for financial or organizational reasons. As part of this study, KLAS interviewed more than 400 large and small practices across the country about their EHR solutions.

Of respondents who recently switched EHRs, more moved away from GE Healthcare and NextGen than any other vendors. Looking forward, Allscripts, GE Healthcare, McKesson, and NextGen stand to lose more customers than other vendors, as 40-50 percent of their responding customers reported potential plans to leave. Additionally, the report found that customer satisfaction with McKesson, NextGen, Allscripts, and GE Healthcare is relatively low, and customers report less confidence in these vendors’ meaningful use readiness.

Inpatient and outpatient integration is driving change on the larger end of the market, as providers replace acute/ambulatory EHRs simultaneously or deploy their acute EHR vendor’s solution to clinics. Midsize practices report swapping over usability reasons or to standardize from multiple EHRs to fewer. Smaller practices are driven to change over usability issues, poor support, and cost constraints.

Further, the KLAS report found that size does highly influence providers’ health IT plans. Smaller practices not yet tapped out financially are considering lower-cost technologies like kiosks and patient portals. Large practices are focused on population health–related tools, followed by health information exchanges (HIEs) and kiosks. Midsize practices fall in between, with about 20 percent considering patient portals, HIEs, and population health tools.

As larger practices have tightened their relationships with nearby hospitals for population health considerations, Epic’s and Cerner’s integrated platforms have benefitted most in mindshare. While providers have long considered Epic a viable ambulatory EHR option, Cerner has made significant progress recently with their ambulatory solution, and providers now consider it a legitimate option. athenahealth and Allscripts—who was once the mindshare leader—are next most considered, though well behind, by affiliated entities.

Independent practices, which tend to be midsize to smaller practices, mention a myriad of vendors, but give top consideration to athenahealth and eClinicalWorks, followed by Epic and Greenway, in their quest to resolve functionality, support, and cost concerns.

Since 2011, increased demand for acute/ambulatory integration helped Cerner more than triple in mindshare and Epic more than double. Independent practice considerations helped athenahealth’s mindshare quadruple. McKesson’s mindshare grew thanks to the upcoming Paragon ambulatory product, the report found.

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